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FEATURE: MENTAL HEALTH & WELLBEING


borderline personality disorder… and all the while, the teenager’s life story remains unheard. Diagnosis and disorder stop us looking at the very difficult lives that some children and teenagers are living.” A great many people believe that ‘disorders’


gaining entry into the DSM-V are all backed by biological evidence. In actuality the ‘disorders’ are decided by a small committee who vote on whether something should be called a disorder and then what threshold you have to reach to get the label. As James Davies, Reader in Mental Health, University of Roehampton, who studied the minutes from all the DSM committee meetings states, “Voting isn’t a scientific activity.” The National Institute of Mental Health (NIMH)


has now withdrawn funding for DSM due to lack of scientific evidence. “Patients… deserve better.. The weakness is its lack of validity.” (Dr Thomas Insel, former NIMH Director). DSM-5… offers a reckless hodgepodge of new diagnoses that will misidentify normal and subject them to unnecessary treatment and stigma… There is no reason to believe that DSM-5 is safe or scientifically sound.” (Allen Frances Chair of DSM- IV committee). Allen Frances has deep regrets about the


changes to his version of the manual which lead to over-diagnosis/diagnostic inflation. “We made mistakes that had terrible consequences,” says Frances. “Diagnoses of autism, attention-deficit hyperactivity disorder, and bipolar disorder skyrocketed.” In Trauma Informed Schools UK’s work with


over 3500 schools, we see this diagnostic inflation/misdiagnosis all the time (e.g., children with poor eye contact being labelled ASC or an agitated child labelled with ADHD and no one taking a trauma history, in other words, no one asking, “What’s happened to him?”) I will always remember talking at a public health conference and the Head of the Autism service in Cornwall saying, “Could you please get all these schools to stop sending us children who they believe are ASC but it’s unaddressed trauma.”


The ‘manage your feelings’ model of human distress PSHE curricula teach you to 'manage' your feelings. It’s been the same for years. In our work for TISUK (training over 20,000 teachers), we are repeatedly told that CYP can’t relate to the above. They say they find it boring and patronising. as it doesn’t speak about the painful reality of their lives. They just want someone to talk to. Also, research shows that exercise,


mindfulness, using nature etc as common PSHE mental health interventions don’t work to alleviate the pain and symptoms of unprocessed trauma, due to traumatic memories being locked into particular neuronal networks. Only relational interventions work 5.


The pupil/student led model Let me make it clear from the start, that school staff trained in this model understand limits of competence and know when to refer on to the GP/mental health services. That said, from our work in thousands of schools, it is crystal clear that CYP don’t want a disorder label or coping skills to ‘manage their feelings’, or lectures on resilience, they just want someone to talk to them about the painful events in their lives. This has


June 2019


been brought home to us through our, “I wish my teacher knew” intervention. Here are a few examples from students, ”I wish my teacher knew that… …I feel helpless and alone …I wake up not


wanting to carry on ….Gran died this year and now my mum is sad all the time, so it’s like I’ve lost my Mum and my Gran …My parents fight all the time …I don’t feel I matter to anyone.”


You might be thinking, well, just send them all


to the school counsellor. Sadly, the maths doesn’t add up. Whilst school counsellors can see some children in each school for some sessions, it’s a drop in the ocean as we currently have one in six children with mental health difficulties which adds up to well over a million. We need an army! We have one! If all school staff who are naturally warm and empathic are trained in active listening and trauma-informed practice, then all vulnerable CYP could have an emotionally available adult (EAA) as a secure base. This model is based on a) a wealth of evidence-base research called the social buffering studies, showing that one EAA before the age of 18 interrupts the progression from childhood adversity to long term mental and physical ill-health, b) the neuroscientific evidence that feeling understood and regularly receiving mental state talk, empathy, active listening from an EAA has a dramatic impact on alleviating mental health problems. 6 Critics will say, “Gee! Piling yet more work


onto our over-worked teachers!” The graduates of our training say they feel invigorated by this work not worn down. They say it’s because the training has not only empowered them to make a huge difference to children’s lives but has also improved their relationship with their own children and partners. (We also implement on- going psychologist-led supervision to support them in this vital work). And it’s the quality of their time with vulnerable CYP not the quantity. We are not turning teachers into quasi-


psychotherapists, simply replicating what happens in best parenting. Furthermore, research for the Government Green Paper, ‘Transforming Children and Young People’s Mental Health Provision’ (2017), states: “There is evidence that appropriately-trained and supported staff such as teachers… and


Children and young people need to know that strategies to calm their body and mind cannot alleviate symptoms that have resulted from traumatic life experience. So after their mindfulness, exercise or changing negative thought patterns, if they have suffered from any of the following symptoms before, they will still suffer from them afterwards:


None of these will be alleviated: Obsessive compulsive rituals Nightmares/trouble sleeping Hearing voices Body hatred Phobias


Panic attacks Self-harm Self-blame Self-hatred Flashbacks Eating disorders Dissociation Blocked trust


Using sex to seek attachment (teenagers) www.education-today.co.uk 41


teaching assistants can achieve results comparable to those achieved by trained therapists in… addressing mild to moderate mental health problems.” For this model to fly, all trainee teachers need


training too. This is happening right now in Sheffield Hallam University which includes a compulsory module of trauma-informed training in every level and age phase of their initial teaching education. If we don’t invest far more in this pupil/student


led model for mental health, all too many staff will continue to reach for behaviour modification, ‘disorder labels’, CAMHS year long waiting lists, or getting children to ‘manage their feelings’. All these serve to alienate further those children in emotional pain, who just want someone to listen, hear their story now, and know that they matter. For more on Diploma in Trauma and Mental


Health in Schools and Communities (10-day training) see uwww.traumainformedschools.co.uk


References 1.Younger, R. (2021). Youngsters face up to four years for mental health. ITV News. March 24, 2021


2. Children’s Commissioner for England (2020). The State of Children’s Mental Health Services Report 2020/21, London.


3. Johnstone, L. & Boyle, M. (2018). The Power Threat Meaning Framework. Leicester: British Psychological Society.


4. Read, J. and Sanders, P. 2010. A Straight-Talking Introduction to the Causes of Mental Health Problems. Ross-on-Wye: PCCS Books.


5. Ecker, B. (2015). Memory Reconsolidation in Psychotherapy: The Neuropsychotherapist Special Issue: Volume 1


6. Sunderland, M. (2021). Full references print out with key webinars on child mental health CPD (www.traumainformedschools.co.uk)


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