Mental health can be defined as “a state of well-being in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully and, is able to make a contribution to his or her community” (World Health Organization, 2003). According to the Northern Ireland Assembly Research and Information Service (Betts & Thompson, 2017), it is estimated that around 45,000 children and young people in Northern Ireland at any one time have a mental health problem and more than 20% of young people are suffering from significant mental health problems by the time they reach 18. Clearly, child mental health is an area of concern in Northern Ireland. More recently, there is the acknowledgement that educational and health outcomes are indistinguishably linked, and that school can be the perfect setting which can strive for both (World Health Organization, 2003).
Impact of Child Mental Health Issues
There is an increasing concern about the growth of mental health difficulties in children (Baxter, 2002). These mental health difficulties can be major obstacles to learning and academic attainment in schools (Catalano, et al., 2004). According to Fazel et al (2014) it can impact upon the cognitive and social development of children. Previous studies have found that early indicators of poor mental health are linked to poor quality of life (Rothi, et al., 2008) and an increase in substance abuse, unemployment, suicide in later life and criminal activity (Fergusson, et al., 2005). The effects of poor mental health are damaging not only for the individual child as they grow and develop but also for society as a whole as nearly £17 billion is spent in England and Wales per year on late intervention (NSPCC, 2016). Therefore, intervening early is one of the most cost-effective ways to improve mental health amongst young people.
The Role of Teachers
Child mental health is everyone’s business. Emotional development needs to be an integral part of every school’s curriculum, ethos and life (Orbach, 1998). The United Nations Convention on the Rights of the Child (UNCRC) states that teachers need to develop both children’s mental and physical abilities. Therefore, according to health policy documents, teachers are expected to assume the responsibilities of front-line tier one mental health professionals. As there is no single cause of this dramatic increase in mental health issues and each child is an individual, it is proving difficult for teachers to tackle. Society’s expectation of teachers is growing. Teachers are now expected to be responsive to a range of student situations and needs (Graham, et al., 2011).
The Role of Schools
Schools are in a unique position, as they have access to the whole population of children on a daily basis (Nikolaou & Markogiannakis, 2017). Headley and Campbell (2013) agree that schools understand what constitutes as typical behaviour for each student, and therefore, will have a clearer understanding of when the child is not themselves. The Northern Ireland Curriculum (2007) does not specifically present guidelines to the teaching of mental health. However, in each key stage the first strand set out in the Personal Development and Mutual Understanding booklets is specifically related to personal understanding and health. During this section teachers have to discuss with children, for example, emotions, self-esteem, abilities and strengths. Teachers now have a responsibility to develop, implement and monitor interventions for children presenting with difficulties in school both socially and emotionally (Graham, et al., 2011). A further advantage of using school as a medium to support children is that schools can provide a potentially less stigmatising access point for early intervention and treatment (De George- Walker, 2012). Research has found a growing link between school characteristics and teacher influences on children’s social and emotional outcomes (Lynn, et al., 2003). Therefore, schools need to place emphasis on the promotion of mental health promotional activities as such suggested by the World Health Organization (2003). They suggest that schools need to ensure that they are child friendly schools which provide regular social and emotional education to all students and develop a whole school approach to wellbeing.
Difficulties in Schools
In an ideal world, adequate training and funding for resources would be available to all teachers to enable them to support every child as and when required. However, the reality appears to be very different. The lack of training teachers face is without a doubt a major barrier to the implementation of positive mental health activities within schools. Research has indicated that teachers often do not feel properly equipped with the skills for coping with the reality of the modern classroom (Koller & Bertel, 2006) (Graham, et al., 2011) (Skilbeck & Connell, 2004). Budget cuts within education are another difficulty that schools are facing. Budget cuts have resulted in less support from outside agencies to aide teachers when tackling these issues. It has also meant that teachers are now being relied on for early identification, without any outside professional support (Graham, et al., 2011). Furthermore, funding has not been made available to schools for provision of well targeted in- school support. This is alarming as the waiting list for Child and Adolescent Mental Health Services is only increasing and there has been a 10% increase in the number of children waiting over 12 months for an appointment. This results in teachers being the next source of support for children facing mental health issues. In addition, teachers are facing a range of factors disabling them from tackling this area of the curriculum, such as competing curriculum demands and the strive towards literacy and numeracy throughout the United Kingdom. In addition, there is limited time for planning and implementation of wellbeing programmes and lessons and the lack of resources and leadership availability and support accessible for teachers. These factors result in teachers feeling unable to support children and their mental wellbeing in an effective way.
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The dramatic rise in mental health problems in children has sparked the researcher’s interest in this topic. From having spent two years on School Based Work and volunteering regularly in a school, the researcher has observed the pressure placed on teachers to be more than simply teachers. The research has also observed how PDMU lessons are rarely taught and how mental health does not appear to be addressed in schools.
Aim of Study:
The above literature demonstrates the ever-growing child mental health dilemma throughout Northern Ireland. It shows the impact poor mental health has on children both throughout their childhood and continues into adult life. Research has previously demonstrated the positive influence schools and teachers have on children from early intervention. However, this study seeks to discover the challenges that teachers face when undertaking such issues in school. Therefore, the study will aim to answer the following four questions:
- Do teachers in Northern Ireland regularly teach children about positive mental health?
- Do teachers feel confident and equipped to support a child/children who present with mental health difficulties?
- What support (if any) do teachers receive?
- What difficulties and challenges do teachers face with regards to mental health teaching in schools?
Design of Study
This chapter outlines the overall approach and research methods employed to conduct this research. It entails how focused group interviews and questionnaires will be administered to explore teachers’ confidence and abilities to teach positive mental health to primary school children. In addition, ethical procedures during this research will be provided.
Marshall and Rossman (2011) state that the choice of a research methods should flow organically from the questions. This is a point echoed by BERA (2011, p. 9) who suggest that ‘researchers must employ methods that are fit for the purpose of the research they are undertaking’. Denscombe (2008, p.134) advocates researchers using ‘more than one method when investigating a topic.’ This study seeks to obtain a combination of qualitative and quantitative data. King, Keohane and Verba (1996) advocate mixed methods approach. They argue that better research utilises both qualitative and quantitative research as most research does not fit into one category. Furthermore, Sharp (2012) advocates the use of more than one research method as it offers the opportunity to “triangulate.” This helps the researcher reduce ambiguity, increase confidence in findings and be able to cross reference, in addition to ensuring reliability and validity.
The questionnaire suggested will include both quantitative and qualitative questions. Questionnaires offer benefits of open and standardised responses from a large sample, enabling a generalized view from a large group of teachers. They can also be ‘cheap, reliable, valid, quick and easy to complete’ (Cohen, 2018, p. 471). The quantitative questions will allow for generalisations to be made through comparing and analysing the responses, thus producing statistics (Ghuman, 2010). The qualitative aspect of the questionnaire will allow for a more in-depth perspective from teachers and will allow for critical contributions. The questionnaire will enable teachers to share their opinions regarding the place of PDMU in their school and its importance.
However, due to the impersonal nature of the questionnaire process, the research is unable to clarify any queries or to ask further questions to find out more information if an issue should occur. The focus group interview will allow for further exploration of the current situation in schools and will focus on the challenges schools face today with regards to the teaching of mental health. Stokes and Bergin (Stokes & Bergin, 2006) stated that focus groups offer greater breadth and context. Guest et al (2017) found that certain sensitive and personal disclosures were more likely to emerge in a focus group. Therefore, the researcher can focus on findings from the questionnaire that require further questioning and explanation.
To obtain data regarding this study, the participants in this research will be chosen from Foundation Stage, Key Stage One and Key Stage Two settings of a range of Primary Schools. The questionnaire will be given to around 30 schools across Northern Ireland in the hope to obtain a wide response, in the hope of making a general statement (Driscoll, 2011). A wide range of primary schools will be contacted so that the results will avoid bias and will be inclusive.
With regards to participant selection for the focused group interview, this will be based on self-selection. This will be indicated on the questionnaire for the participant to decide whether they would like to attend a focus group for further questioning and discussion. By using a self-selection approach, it suggests that the participants will have a greater interest in the study and perhaps be more willing to provide an insight (Gall, et al., 1996).
Analysing the data
The data from questionnaires will be collated using Microsoft Excel. This method is supported by Drisko and Maschi (2015) who state that it allows comparisons to be made of both quantitative and qualitative data which can be reorganised into emergent and recurring themes.
The focused group interviews will be recorded and transcribed. Recordings will allow the researcher to consider voice tones, inflections, pauses and moods in order to use the data to its fullest potential (Cohen, et al., 2011).The data will then be organised into recurring themes, including current practice, challenges and training.
When considering collected data, the researcher will need to cross reference. The researcher will need to observe whether there is a link between age of the teacher and their confidence in teaching about mental health. Another area will be to observe whether there is a pattern within the year groups. For example, are key stage two teachers more likely to avoid mental health lessons because of the risk of more sensitive topics and conversations?
When conducting any research, ethical considerations need to be assessed and reviewed. The ethical considerations need to follow the guidelines of the British Education Research Association (BERA) and as the BERA (2004, p. 6) highlights “Researchers must take the steps necessary to ensure that all participants in the research understand the process in which they are to be engaged”.
Before the research will take place, formal permission will need to be obtained from Stranmillis University College to ensure that the research questions and aims are appropriate and are within the college’s ethical guidelines. The researcher will ensure that there is written and verbal consent from both teachers and principals in each school. The researcher will ensure that both the principal of the school and teachers understand the purpose of the research and how their responses will be used and who will have access to them. This is supported by Denscombe (2003, p. 134) who states that researchers are “expected to respect the rights of the participants, avoid any harm caused by their involvement in the research and run the study in an honest and reliable manner.”
Confidentiality is a major ethical issue when completing research. The questionnaires will be delivered to schools with an accompanying letter explaining how their confidentiality will be respected. The researcher will state that completed questionnaires should be placed in individual envelopes to ensure anonymity. Furthermore, the right of an individual or school to not be involved and also to be able to withdraw from participation at any point will be fully respected in this research.
In conclusion, this study will aim to explore teacher’s confidence and abilities to promote and teach positive mental health to primary school children. Through a mixed methods approach, the researcher will aim to discover the frequency of mental health teaching in schools and the reasons why teachers do not teach it. The researcher will seek to discover the challenges and demands that teachers face in school that prohibit their ability to teach mental health effectively.
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