Health Anxieties in Children – How to Spot Early Signs
By Kate Sheppard As human beings, it is normal for us to feel an amount of anxiety. This is also true for children. Many children are afraid of the dark or nervous about meeting new people and making new friends. This is normal. However, sometimes, what begins as normal anxiety levels in children can increase into something more substantial. Pupils in any year group can develop anxiety disorder. What you need to know is how to spot the early signs. In this article, we will be discussing health anxieties in pupils and how you can spot the early signs of this condition so that you can take the appropriate next steps. What is Health Anxiety? Health anxiety is a specific form of anxiety where a person becomes obsessively, and often unnecessarily, worried about their health. Health anxiety is more commonly known by the term ‘hypochondria’ and is a prevalent anxiety condition in both children and adults that has a significant impact on the individual’s quality of life. What Causes Health Anxieties in Pupils? Anxiety, like most mental health conditions, does not have the same cause for everyone. What causes one pupil to develop health anxiety, may not cause it for another. There are different causes of anxiety and some are more obvious than others. As educators it’s vital to identify some of the most common causes of health anxieties in pupils. These are usually the result of: Common Symptoms of Anxiety in Pupils Just like adults do, children exhibit symptoms of anxiety in very different ways. However, if you suspect a pupil of yours is struggling with anxiety, below is a list of common symptoms to be aware of: How to Spot the Early Signs of Health Anxiety in Pupils As we have already discussed, health anxiety is a specific form of anxiety that focuses predominantly on an individual’s health or perceived lack thereof. Health anxieties in pupils can be worrisome as they can have a significant impact on a child’s normal development and functioning. Therefore, many teachers are keen to spot the early signs of the condition so they can take the necessary steps to provide support. Below we share how as teachers we can spot the early signs of health anxiety in pupils. If you notice a pupil is often exaggerating the severity of minor health conditions – for example, assuming a headache is the sign of a brain tumour – this is often a telling sign they are struggling with health anxiety. Another common sign of health anxiety is frequently asking to go to the school nurse. Children suffering from health anxiety want to see the nurse as often as they can, either to report new conditions they are worried about or to seek reassurance. However, the flip side to this is that some children with health anxiety do not find any reassurance from the nurse and instead assume their diagnosis – or even their test results – are incorrect. Children with health anxieties tend to become so preoccupied with the state of their health, or lack thereof, that they struggle to function well during class. Signs that a pupil of yours may be struggling to function will be specific to them, however may include things such as difficulty concentrating, lack of energy, little to no appetite, no interest in activities they previously enjoyed, and difficulty enjoying themselves. Children that obsessively check their bodies for signs of illness tend to be showing signs of health anxiety. A child in your class could be doing this because someone close to them has died from a specific illness or injury. Alternatively, they could be obsessively checking because they’re worried about developing a medical illness that runs in their family. Whatever the cause, repeatedly checking the body for signs of illness is a typical sign of health anxiety in children. Next Steps: Seek Professional Help If you have noticed that a pupil of yours is showing signs of health anxiety and you are concerned, it is important to reach out to the child’s parent to discuss your observations and concerns. Rest assured that spotting the signs early can go a long way towards affecting a positive outcome for your pupils. Final Words We hope this article will help you spot the early signs of health anxiety in your pupils so that you can take the appropriate next steps. According to The New York Times, “opening a dialogue with children about how they are feeling and listening without judgement are critical.” Be encouraged that health anxiety is a treatable condition and there is plenty of support available, should your child need it.
Teachers offered training to identify pupils at risk of self-harm
Headteachers, teachers and teaching assistants across the East Midlands and beyond are being invited to free mental health workshops next week which will tackle identifying self-harm and anxiety disorder in young people. The sessions are being held as part of the county’s first mental health festival Headfest, which kicks off on Monday 9 May which also marks the start of Mental Health Awareness Week. Paul Hanrahan, who is a teacher at the St Andrew’s Healthcare College, will be delivering two talks which are based on the mental health awareness programme LightBulb which the college has written for primary and secondary school children. Paul said: “We know the pandemic has had a profound effect on some children’s mental health, and even before we experienced the lockdown anxiety numbers among young people were already high. At St Andrew’s we care for some very poorly young people who have not received the help they needed until it was too late, leading to them needing to come into hospital. It is a worrying situation and the role schools can play in recognising and supporting mental wellbeing is paramount in ensuring young people have access to support when it is most needed. “LightBulb is all about equipping our young people with the skills they need to be resilient and seek help about mental health issues, hopefully reducing the distress they experience and positively impacting the outcomes they experience. We believe early intervention is essential and can make a huge difference to the wellbeing of those children who are experiencing mental health issues. “We’re thrilled to have been asked to take part in Headfest and provide teachers with a brief introduction to our programme, which could make all the difference in helping a young person who may be silently struggling.” Paul’s first session will focus on self-harm and will take place at the Royal & Derngate on Wednesday 11 May at 11:30am to 12:30pm. The second session about recognising anxiety disorder is being delivered on Thursday 12 May between 1pm-2pm.For more information about Headfest, visit https://www.royalandderngate.co.uk/whats-on/headfest-2022/ To find out more about the St Andrew’s Healthcare LightBulb programme go to https://www.stah.org/education/light-bulb/
Are you integrating PSHE and emotional wellbeing across your curriculum?
Be Ofsted ready with ZunTold publications and teaching guides. Available from Peters and other leading educational distributors. Face in the Mirror – A teaching manual to support students’ mental health, was published by ZunTold, a specialist publisher of texts supporting mental health and the PSHE curriculum. It contains 54 poems, collated around 11 themes of wellbeing, detailed commentaries and curriculum specific lesson plans. Accompanying the teaching manual is a students’ guide. At 410 pages, the teaching manual retails for £60 but with discounts to schools available and with cross-curricular approach, it is an excellent investment for the English and PSHE department. Written by Judy Morris, who taught as a classroom teacher for over twenty-five years before she became a headteacher, Judy’s experience includes specialisms in English, special educational needs and disability (SEND), and personal, social, health and economic education (PSHE). Judy explains, ‘Poetry is an ideal form for developing speaking & listening skills and can be taught as part of the key reading, writing and speaking and listening areas of language development. But its effect and educative value are not limited to language development. Poetry can have a positive impact on the social and emotional learning of young people, and can provide them with a healthy outlet for their emotions as well as a means of accessing and understanding those feelings.’ Judy Morris has written a unique teaching guide, intended to help young people to explore issues associated with mental health, wellbeing and relationships. The lesson plans provide opportunities for young people to talk about worries and concerns, to see their connections with others and with the world around them, and to empathise with others. The aim is to move away from stigmatising mental health problems, a state of affairs that still persists in society, and to be able to talk about mental health and wellbeing issues in a normalised, accepting and supportive forum. Judy Morris is available for teacher training workshops and student workshops – topics such as how to integrate pupil wellbeing into an already busy curriculum, or Plugging the Covid gap; restoring fluency through poetry and many others. We would be happy to send schools a detailed guide of what is available for schools and the publisher is happy to take direct orders for the Teachers’ Guide and students text books. Please contact elaine@zuntold.com or call 07974 190136
Dealing with student suicide – help when you need it most
With students’ mental health being such a high profile concern after the last two challenging years, it may be a good time to ask if your establishment is prepared for the worst possible scenario? Being ‘suicide ready’ is an uncomfortable and unattractive notion. It is, of course, a devastating event if it happens in any school, college or university. What do we do? How should we respond? Where do we start? Samaritans specialist Step by Step service for schools, colleges or anywhere young people come together, is available to help. There is no charge for the service. The response to a suicide in any institution needs to be prompt, proactive and proportionate. It needs to have clear priorities. All of this can be achieved in a professional and well-organised manner if it has been thought about, discussed and planned in advance. A comprehensive ‘Critical Incident Plan’ which is specific enough to account for a death from suspected suicide, (as opposed to one through illness or accident) is strongly recommended. Samaritans’ Step by Step service offers these three strands of support. Helping to create an effective Critical Incident Plan A trained Step by Step Advisor can meet with staff to help create a ‘Death of a Student through Suspected Suicide Policy.’ A plan is created based on good practice gathered from working with a range of educational establishments. If there is no plan in place, the session can help create an outline which can be adapted to meet the school/university and its individual circumstances. If there is already such a plan in place, advisors can suggest refinements and identify any gaps. Support in the aftermath of an incident The second area of support is where a death by suspected suicide has just been reported. Following a phone call to the Step by Step administrator an Advisor is allocated. He or she will be available by phone or e-mail and if appropriate, in person, to help guide events, to ask and answer questions, and to assist in any way possible. This may, for example, be help with breaking the news, support for students and colleagues, handling the media, preventing suicide contagion, providing advice on the wording of communications, liaison with the family of the deceased, discussion about memorials, and so on. Most importantly it gives staff someone to turn to for confidential support and advice through an incredibly distressing and challenging time. Reviewing the effectiveness of the Critical Incident Plan after an incident Samaritans can also attend a review meeting, perhaps a month or two after an incident, to help look back at how well the existing Critical Incident Plan worked in managing the aftermath of a death. This has usually presented an opportunity to share good practice and has resulted in amendments to an existing plan in order to manage a more comprehensive response should it be required again. Samaritans Step by Step Advisors cover the whole of the UK and ROI. They have received special and intensive training for work in postvention, critical incident planning and support. All are also active listening volunteers on Samaritans helpline (Freephone 116 123). Step by Step can be contacted by any educational establishment, from primary schools to universities and other Higher Education Institutions. The service is ready and willing to help and support in distressing circumstances. It can be contacted on 0808 168 2528 or at stepbystep@samaritans.org. Content by Geoff Rickson, former headteacher and Samaritans Step by Step advisor
Beat the winter blues: Five ways to get your class moving
The cold weather and dark mornings can make it difficult for teachers to motivate pupils for a day of learning, but research has shown that physical activity can boost productivity and improve cognitive functioning in young people. During Children’s Mental Health Week, Anthony McBride, qualified teacher and founder of edtech app myphizz, discusses the positive impact exercise can have on students’ overall wellbeing and how schools can engage children in an active curriculum. Make maths fun Encourage engagement in core subjects by using games to get children moving. Set up multiple choice questions with an active edge, by providing children with bean bags and asking them to throw these into a bucket labelled with the correct answer. Alternatively, mark four corners of a hall with multiple choice answers and ask pupils to run to the correct answer. Take a nature walk Plan a short route around the school grounds and ask children to take in their natural surroundings, listing the different trees, plants, and insects that they come across. Nature walks provide a great opportunity to be mindful and connect to ourselves and the world around us. They can be lots of fun to do with your students, can help cultivate a sense of awe and wonder, and get them moving after periods of sitting or inactivity. Active playtimes Energise morning break times by setting up quick fitness challenges including star jumps, skipping, high knees and mountain climbers. Ask pupils to complete as many repetitions as they can in 20 seconds and keep a record of achievements. Pupils could use myphizz to create leaderboards to motivate each other to take part in challenges. The friendly competition will encourage children to get active between lessons and allow them to return to class much more focussed and ready to learn. Stand up Assemblies Almost all primary schools in the UK hold a daily or weekly assembly. It’s customary for pupils to spend this time sitting on chairs, benches or on the ground. Why not shake things up and ask them to stand for shorter assemblies? Classes could even perform a movement of the day together! Rise & Shine! School based breakfast clubs are a popular way to help children start the day right. It’s easy to add movement and turn these meetings into mini activity sessions. You could host a morning yoga session, for example, or even take children on a mini run to boost their energy and alertness. The immediate and long-term health benefits of physical activity are indisputable and there is a wealth of evidence to demonstrate that exercise reduces the symptoms of anxiety and depression in children. Studies have also shown that aerobic exercise promotes cardiovascular fitness, which, in turn, promotes the growth of new blood vessels and improves circulation in the brain. Therefore the more physically fit a child is, the larger his or her hippocampus tends to be and this has positive links to a child’s learning and memory². Reaching young people in a safe, fun and engaging way, empowers children to take control of their own physical activity and provides them with opportunities to try new activities, develop their skills and experience whatever level of physical activity and challenge feels right for them. For more information, please visit myphizz.com.
Concern over pupil anxiety levels as pandemic continues to disrupt schools
The vast majority of staff working in UK schools (95%) have witnessed increased levels of pupil anxiety since the start of the school year, in contrast to a normal autumn term before the pandemic. That’s according to a new poll of education professionals released today by children’s mental health charity Place2Be and school leaders’ union NAHT, ahead of Children’s Mental Health Week 2022. The survey of 1,130 school leaders, teachers and other staff working in primary and secondary schools, reveals the challenges they are still facing, even as some are suggesting that ‘the end of the pandemic is in sight’. Those surveyed have also seen an increased prevalence of other mental health issues among pupils this school year, with 86% noting an increase in low self-esteem, 76% in depression and 68% in sustained feelings of anger. For staff working in secondary schools, 72% have noticed an increase in self harm, 61% in suicidal thoughts, and 56% in eating difficulties among pupils. Only 23% of staff said they had regularly3 been able to access specialist support for pupils with mental health needs, leaving a majority of children and young people struggling without access to the support they need. School staff highlighted the wider impact on many aspects of school life. A large majority of school leaders and staff said it has negatively affected pupils’ ability to engage in learning (91%), pupils’ behaviour (87%), and pupils’ progress (86%). There has also been an impact on teachers and staff themselves – with 91% noting a negative impact on staff workload and capacity, and 89% on staff wellbeing. Catherine Roche, Chief Executive of Place2Be, said: “As society tries to regain a sense of normality after two challenging years, we must remember that school leaders and staff remain on the frontline, coping with all the additional needs that pupils are bringing through their gates. We know that with the right embedded specialist support, schools can be a fantastic place to address issues early on and promote positive mental health. There has never been a more important time to ensure that schools, and therefore children, receive the support they deserve.” Paul Whiteman, general secretary of school leaders’ union NAHT, said: “The findings of this survey are truly shocking – but unfortunately, to anyone working in schools, they are not surprising. Our members consistently raise pupil mental health and wellbeing as one of their top priorities – they really are on the front line when it comes to identifying and supporting children and young people’s mental health needs. “It’s crucial that when school staff identify a mental health need with a pupil they are able to get the specialist help that is required. But as our survey shows, very few school staff find they are able to access specialist support for pupils who need it in a timely way – and this is having a negative impact on pupils’ ability to engage in learning, as well as on school life and staffs’ own wellbeing. “These shocking new stats should add real urgency to the call for additional resources to support the mental health and wellbeing of pupils. The government must ensure that every school has fully funded mental health support available for their pupils and it is essential that they increase the capacity of social care, health and other services to meet the growing demand and to reduce waiting times.” Additional survey findings include: Children’s Mental Health Week 2022 takes place on 7 – 13 February, and this year’s theme is ‘Growing Together’. Place2Be launched the first ever Children’s Mental Health Week in 2015 to shine a spotlight on the importance of children and young people’s mental health. Now in its eighth year, the message of the week has never been more vital. Children’s Mental Health Week is kindly supported by players of the People’s Postcode Lottery and The Beaverbrook Foundation. Web: www.childrensmentalhealthweek.org.uk
Major study shows staff wellbeing in schools is on a knife edge
Teachers are reeling from the shock of the pandemic as the continued pressures on them are taking a lasting toll on their wellbeing, according to the latest Tes Staff Wellbeing Report. Worryingly, just 38% of the UK teaching population surveyed feel confident in their roles. The report shows how school staff are battling unmanageable workloads exacerbated by inadequate resources and a lack of flexibility, as well as limited opportunities for career development. Poor school staff wellbeing could lead to absenteeism, long term sick-leave or even valuable school staff quitting the profession. These all have serious implications on student outcomes, fellow teachers, and can also prove costly for already cash-strapped schools. The concerning conclusions of the 2022 Tes Staff Wellbeing Report include: Self-belief among school staff has taken a major blow, with now only 38 per cent of UK respondents saying they feel confident performing their role, compared with 79 per cent in last year’s Tes survey. 67 per cent of UK teachers said their workload simply isn’t manageable – much higher than the international average of 36 per cent across the survey. Almost half of school staff said they feel they don’t have a voice about how things go at their school, and a similar number said they feel they don’t have the autonomy to make decisions. This is particularly true for teaching staff: 57 per cent of teachers and 41 per cent of middle leaders said they lack autonomy. 47 per cent of UK respondents said there aren’t opportunities for them to develop in their current position, with only a fifth (22%) feeling that there is. School staff are enjoying their work less. More than half of those surveyed said they do not find work fun, with less than a fifth saying that they do (down from 45 per cent last year). While 81 per cent of UK respondents said that they get a sense of belonging to a team in their current roles, only two-fifths of those surveyed said they feel that their colleagues care about them. This is a substantial drop year-on-year; in 2020, the majority of respondents (66 per cent) said they felt their colleagues care about them. Tes Senior Analyst Grainne Hallahan said: “This report shows the damaging effects of the pandemic on the wellbeing of school staff are going to be with us for some time. Teacher wellbeing is on a knife edge as they struggle with increased demands, mounting workloads and a real lack of good CPD. Staff in schools are enjoying their work less and most don’t feel valued as part of a whole school team. “These are worrying findings for schools, but these problems are not insurmountable. By offering staff the right support, training and knowledge that their voices are heard and understood, senior leaders have the opportunity to inspire a dramatic shift in wellbeing at their schools, with all the benefits for teacher retention and pupil outcomes that will bring.” Sinéad Mc Brearty, CEO of Education Support, a charity dedicated to supporting the mental health and wellbeing of staff in schools, colleges and universities, said: “School staff continue to display an incredible capacity for adaptability, focus and resilience. But teachers and other school staff are struggling with heavy and intense workloads. They are struggling with work-life balance and often don’t receive enough of the right support. “This report sheds light on the severe impact of the pandemic on the teaching profession. Wellbeing has to be at the heart of our education system, and a central part of the education recovery agenda. Proper recognition of the importance of teacher mental health is essential to support the people who are responsible for teaching and inspiring our children. Katie Shearer, a principal teacher at St Patrick’s Primary School in Glasgow was featured in the Tes Staff Wellbeing Report. She said: “The vocational commitment of teachers should not then be used as a vehicle to overwork, guilt trip or compromise teacher mental health. Our commitment to the profession at times can leave us feeling very self-critical, under pressure and trying to manage an overwhelming amount of stress. If practitioners want to be able to make a real difference, our health and wellbeing needs to be a priority, now more than ever.”
Play and arts therapy experts Clear Sky are helping children boost their mental health
At least three children in every UK classroom will have a diagnosable mental health difficulty. Many more will be struggling with psychological difficulties which impact on their learning such as anxiety and low self-esteem. Play & Creative Arts Therapy creates a safe environment for children who are finding it difficult to explore and express themselves, through the language of play. By also offering support to parents, and providing professionals with specialist skills we can help parents and carers to better understand the emotional needs of the children in their care and attend to them appropriately. Ultimately this leads to improved emotional wellbeing and increased resilience putting them in good stead for a happy and healthy future. Clear Sky Children’s Charity are experts in Play and Creative Arts therapy. We work in schools providing 1:1 and group therapeutic interventions to children who have experienced trauma, or who may be experiencing emotional or behavioural problems. All of our sessions are child-led and are delivered by experienced and fully qualified Play and Creative Arts professionals. We support schools through our Attachment-Play based learning programmes and offer a range of CPD in-school training which is supported in turn by our online ‘Emotionally Healthy Schools’ framework; giving settings the opportunity to embed the principles of good emotional health to support their entire community through the use of resources, games and videos. We work with groups of parents and in groups of parent-child together to help strengthen the important relationship between child and carer through the medium of Play. At the beginning of lockdown as this face to face support was not possible, we created a 94-page practical Parents Play Kit, full of ideas for parents to use at home with their child to build and strengthen communication, understanding and empathy, and create time and space for parents to connect with their child. Our Play Kit was downloaded thousands of times and made available in print for therapeutic practitioners and professionals working with children. We work with the National Education Union as part of their CPD programme, delivering our Space to Shine programme for NQT’s and experienced teachers alike where we enable professionals to practice play! Finally, we provide support for those professionals who are working within the therapeutic sector to enable them to access the very latest research, resources and learning through our online membership body ‘The Institute for Play and Attachment’. Our aim is to support all children to survive and thrive through ‘The Power of Play’! To find out about how Clear Sky’s services and to download a copy of our Parents Play Kit, or to enquire about our school training and resources, please visit our website: www.clear-sky.org.uk or email us at: info@clear-sky.org.uk
How to get boys to open up about their feelings – a case study
Emotional health training organisation Mind With Heart is on a mission to help schools flourish and build a more compassionate society. Here the London based charity talks about its ‘Connected With Others’ programme which explores how positive relationships are key to our own wellbeing. It is an interactive and mindfulness-based programme for secondary school students. The aim is to equip young people with essential life skills that will support them throughout their education, as well as in their working and personal lives. The programme cultivates: • Awareness to recognise their own emotions, as well as the emotions of others; • Stability and resilience to be present with challenging emotions, and the ability to refrain from reacting habitually; • Self-compassion and the ability to be kind to themselves; • Emotional intelligence and listening skills, which enables them to give and receive support from others; • Empathy and compassion to be a good friend to others, including those outside their immediate circle of care; and • A sense of common humanity and a readiness to help. One trainer held this course in a London secondary school over a 5-week period of 10 sessions long, and it was delivered over the course of 5 double lessons of 1 hour and 45 minutes each. Interviews with 3 randomly selected boys from Year 9 (ages 13 to 14) were conducted before the training and again after the training was completed. In addition, there was a focus group of 13 Year 9 boys, which was taken at the end of the course. The majority of students were from a Bangladeshi ethnic background. In terms of the general student population at the school, around half were from a low income background, eligible for Free School Meals. Case study – Student 1 (‘S1’) S1 is a 14-year-old boy; he is chatty, enjoys playing sports and his school friends mean a lot to him. When he was asked in his pre-programme interview how he tries to support friends if they’re going through something difficult, he said ‘…if they forget about it and move on then it will help them focus more on different things’. S1 wants to support his friends and be a good friend by cheering them up and distracting them. By not acknowledging how his friends are really feeling, S1 dismisses their emotions. S1’s response was the same when asked whether he felt supported by his friends: ‘I feel very supported by my friends. When I’m feeling sad, they would try to help me forget about it by cheering me up’. In fact, many of the boys expressed the same thoughts on this, which highlights the problem of emotional avoidance rather than addressing and dealing with emotions. In fact, when asked what empathy was, S1 said he had never heard of it and, when further asked what compassion was, he thought that it was ‘being very enthusiastic and keen toward something’. Mind with Heart’s ‘Connected with Others’ programme aims to provide students with greater understanding and the tools to enhance their listening skills, expand their emotional intelligence and nurture their relationships. After the programme, we observed in S1 an increased empathy, readiness to help, courage and openness to approaching emotions. When asked about whether he would approach emotions differently he said, ‘I would. For example, if I was sad before I wouldn’t like to tell anyone, and I would think about it a lot. Now [the programme] made me think about it, I get it off my chest. I’ll be able to get some advice…’. This was echoed across many of the individual participants. It was clear that the training marked a shift in many of the boys, from perceiving themselves and/or others as ‘weak’ if they expressed their emotions, to it being a sign of ‘maturity’ and ‘strength’ to do so. When reflecting on what he had learnt from the programme as a whole, S1 said, ‘it might not sound as important when you have other things like maths and science, but really when you think about it, it could be one of the most important things that people feel around the world’. Case study – Student 2 (‘S2’) In his interview before the programme, S2 said that, if he is down, he would speak to his friends, particularly those he has known for a long time – ‘they kind of understand me’. However, interestingly, he did not feel the same when speaking with his family. ‘Parents might have [experienced the same things], but at the moment they don’t really know.’ The interview also explored gender stereotypes and whether S2 felt pressure from these stereotypes. S2 was acutely aware of stereotypes such as boys ‘don’t cry’ and that they’re ‘meant to be tough’. He further mentioned that he thought ‘some of them [his male classmates] feel shy and embarrassed to talk about how they feel’. Connected With Others encourages participants to investigate emotions, but also aims to provide them with support, confidence and assurance to take home these conversations and continue them with their families. In addition, the exercises and activities aim to re-educate on social gendered norms relating to emotions. For example, one activity required students to create abstract drawings of 8 different emotions. Students shared their drawings with the rest of the group. The activity opened the possibility for the boys to discuss the range of emotions they feel, while normalising the notion that boys experience a broad range of emotions. It seeks to challenge the traditional hegemonic masculine notions of boys only being allowed to show themselves as ‘tough’, ‘stoic’, ‘unemotional’ and demonstrates that boys can feel a wide range of emotions including being sad, angry, anxious, nervous, disappointed, depressed and shy. After the programme similar questions were put to S2. He said that before he ‘would just keep it [sadness] to myself’ and to cope he would play sports. Whereas now, together with playing sports, he would also try to talk about it. Further, when S2 was asked whether there