With 1 in 8 school children and young people of school age having a mental disorder, the content of a mental health curriculum has the capacity to change lives.
Mental Health Today (MHT) readers are calling for the school curriculum to acknowledge the vast number of contested issues, debates, and unknowns that exist in the mental health field. This is in light of the government’s pledge to make mental health education mandatory in schools from September 2020.
Whilst the content for the mental health curriculum is yet to be finalised, it’s due to be debated by parliament in the coming months.
Research by NHS Digital suggests that mental illness is prevalent in the school aged population; one in eight (12.8%) 5 to 19 year olds had a mental disorder when assessed in 2017.
Teaching young people how to critically evaluate whether sources of information are trustworthy would limit the spread of potentially damaging misinformation: a skill that is useful both inside and outside of the classroom. An emphasis upon using a range of sources to make informed decisions creates a culture that encourages young people to be proactive in their learning. From cause, to diagnosis, to treatment, greater transparency is needed.
"It is my personal belief that due to the lack of awareness and education, other students saw those struggling as "weak" as a target for bullying", says Jessica Murray, a trainee counsellor who has Borderline Personality Disorder. "I can't count the amount of times I was called an attention seeker for having panic attacks".
Perhaps if Jessica's peers were exposed to information surrounding the nature of mental illness, they wouldn't have acquired such damaging views.
It is not only in the school environment that children are exposed to potentially harmful views concerning mental illness. Unrealistic media representations are rife in television and film - even in the news. A critical review of mental illness in the news and information media found that they "often present a distorted and inaccurate picture of mental health and illness. Because these media sources are influential, this can have the effect of perpetuating stigma about mental illness".
The government says that secondary school pupils should be taught “how to determine whether peers, adults or sources of information are trustworthy” – 72% of MHT readers agree with this.
"As Education Secretary, I want to make sure that our children are able to grow up to become happy and well-rounded individuals who know how to deal with the challenges of the modern world", says Damian Hinds. "Good physical and mental health is also at the heart of ensuring young people are ready for the adult world”.
Honesty about mental health unknowns
- Classification and diagnosis of disorders
Given that 88% of MHT readers want children to be taught about the mental health disorders framework, issues concerning the classification and diagnosis of mental disorders are extremely relevant.
There is no single authoritative guide on diagnosing mental disorders – both the Diagnostic and Statistical Manuel of Mental Disorders (DSM) and the International Classification of Diseases (ICD) are used. When being taught about the disorders framework, introducing the idea of neurodivergency – Autistic Spectrum and Related Disorders – is important. Whilst a mental disorder is characterised by symptoms that have a negative effect on one’s life, a neurodivergency requires adaptations and accommodations: not treatment because it is not something that can "be cured".
Inevitably, issues surrounding diagnosis should be discussed when being introduced to the mental disorders framework. For example, whilst the Royal College of Psychiatrists say consultant psychiatrists are the only professionals qualified to diagnose the majority of mental health disorders, this is not reflected in practice. Mental health nurses, GPs, psychologists, and even counsellors diagnose people with disorders.
- The causes of disorders
It is not only the classification and diagnosis of disorders that is filled with unknowns; the cause of disorders are not always clear-cut. Whilst the “nature versus nurture” idea is well-known to most people, the causes of mental illnesses are not that simple. For many diagnoses, different pieces of research pinpoint different causes. From biological factors such as genetics and brain chemistry, to environmental factors like childhood trauma, there are a vast number of explanations. And for many disorders, their causality still hasn’t been established conclusively.
NHS Digital found that, in 2017, living in a low-income household or with a parent in receipt of income-related benefits was associated with higher rates of mental disorder in children. This highlights the role of socioeconomic factors in developing mental health issues.
- Treating disorders
Given that there are so many unknowns in relation to the causes of mental disorders, it’s unsurprising that the effectiveness and appropriateness of treatments is contested. Whilst variations in brain chemistry is now often discredited as a cause for mental illness, pharmaceuticals have changed the lives of many people for the better. If a serotonin deficiency is not the cause of depression, then why are SSRI’s (Selective Serotonin Reuptake Inhibitors) so successful in treating some people?
Some treatments for mental disorders are controversial, such as electroconvulsive therapy (ECT): sending an electrical current through a patient's brain to induce a seizure. Efficacy is not only disputed, but patients who have been given ECT often report debilitating effects. Chris Dubey deems it the most traumatic experience of his life, recalling profound memory loss and disorientation. The treatment has even been labelled "misogynistic" and "ageist".
Despite this, others have hailed ECT a miracle cure. Becca, a student mental health nurse, says it "unequivocally" saved her life. She reports no long term side effects and says she would want the treatment if she ever became that depressed again.
The case of ECT highlights the need for transparency when introducing young people to the possible treatments for mental illness. Children should be taught that different people have different reactions to things, be it treatments or trauma.
- See more: Jessica Murray, who lives with Borderline Personality Disorder, calls for better education about mental health in schools
- See more: Read more about our Teach Me Well campaign to influence the national curriculum on mental health
MHT received over 1,200 survey responses to its Teach Me Well survey between 22 October 2018 and 2 January 2019. It has shared its findings with the government through its ongoing consultation on mental health curriculum content.
Updated curriculum plans are set to be shared by the Government’s Department for Education by the end of February.
The Department for Education is proposing that schools are required to teach relationships education at primary school, relationships and sex education at secondary school, and health education at all state-funded schools. Mental health content is set to feature within all three syllabuses.
MHT will publish further results from its polling over the coming weeks, ahead of the national curriculum plan being debated and finalised in parliament in the spring.
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