Mental health literacy, de-stigmatization & identification of early signs of mental health problems

In this session, you will learn more about:

  • What is mental health?
  • Why it is important to address and promote mental health?
  • What are the causes of mental health problems?
  • Mental health literacy: what types of mental health problems are there
  • Other ways to support student’s mental health
Mental health is a very broad topic and it’s easy to lose track. That’s why we have summarised the most important points in the eSano module "Social Mental Health Essentials: Understanding and Supporting Students". You will find case studies, explanations of terms and a guide to what you need to know in your role as a teacher
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What does mental health mean?

Mental health encompasses everything that occurs internally, including thoughts, emotions, concentration, motivation, and memories. Even dreams are part of it. Being mentally healthy isn’t just about the absence of mental illnesses; it’s the ability to effectively adapt to life’s challenges, both positive and negative. It encompasses various aspects of well-being, including emotional resilience, cognitive functioning, interpersonal relationships, and the ability to cope with stress.

It’s important to note that everyone has mental health, just as they have physical health. Like physical health, mental health can coexist with mental illness.

To fully grasp mental health, one must understand its three interconnected components: mental distress, mental health problems, and mental disorders.

Mental health is more than the absence of mental disorders. It is the state of mental well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to contribute to his/her community.

World Health Organization

What are the causes of mental health problems?

Health problems can have a lot of causes and may be influenced by various factors e.g., biological factors, social factors, psychological factors.

Biological factors are related to people’s biology, anatomy, and genetics… for example: chronic illness, trauma, family history of mental disorders or brain infection can influence students’ mental health.

Social factors are related to societal and relationship problems that disrupt mental health. For example, an adolescent spends a lot of time with its family, and problems in this sphere can have a big impact. This also happens with school, where conflicts with peers, academic problems or bullying can lead to mental health problems. Other social important factors are relationships, culture, work, socioeconomic status, housing, social isolation, etc.

Finally, psychological factors that influence mental health include beliefs, attitudes, motivations, emotional responses, and coping responses to life stressors. For example, being sensitive or not having adequate problem-solving skills can lead to negative consequences, such as not having self-efficacy or self-esteem.

While none of these factors alone typically cause problems, their combination can lead to mental health issue

Why is mental health important?

Good mental health is crucial for overall well-being, as it affects how we think, feel, and act. It enhances emotional stability, resilience, and adaptability, allowing individuals to navigate life’s challenges effectively. This is particularly important during childhood and adolescence, where achieving developmental milestones and mastering social skills are essential for maintaining good mental health.
What are the consequences of mental health problems?
Mental health problems can have an impact on physical health and behavior, study performance, social life and many more.
The prevalence of mental health problems

Mental health issues are increasingly prevalent among young people. In Europe, approximately 9 million individuals aged between 10 and 19 are affected by mental health problems. This statistic underscores the likelihood of encountering students facing such challenges in our classrooms.

Worldwide 20% of children and adolescents show signs of mental illness. 4-6% of them need clinical treatment (WHO, 2005).

Why is early detection of mental health problems important?
Researchers have found that early detection of mental health problems can reduce the impact of the disease and the worsening of the symptoms. It also improves recovery. So, there is a higher chance that the person will recover.

  • Early onset: Mental health problems often emerge during adolescence, with around half of affected adults experiencing symptoms that began in their teenage years. Recognizing and addressing these issues early can lead to timely treatment and better outcomes for students.

  • Prevention and intervention: Failure to diagnose and intervene early may cause difficulties in the family, educational, and social realms for children and adolescents dealing with mental health issues. Early intervention can help mitigate the impact of mental health challenges and promote healthier outcomes for students in the long term.

  • Stigma reduction: Many individuals, including young people, struggle to openly discuss their mental health concerns due to stigma and fear of judgment. Fostering understanding and support can reduce stigma and encourage help-seeking.

  • Wellbeing and resilience: Strong mental health promotes resilience, enabling students to navigate challenges and setbacks effectively. Recognizing the importance of emotional and psychological health contributes to a nurturing learning environment where all students can thrive. Acknowledging that students’ emotional and psychological health are as important as their academic success contributes to creating a nurturing and inclusive learning environment where all students can thrive.

  • Social and emotional development: Mental health plays a vital role in students’ ability to develop essential social-emotional skills such as empathy, communication, and conflict resolution. Students with good mental health can better manage their emotions, navigate social situations, and build healthy relationships with peers and adults.

  • Classroom environment: Mental health issues can manifest in disruptive behavior, withdrawal, or difficulty interacting with peers, affecting the overall classroom atmosphere. Students’ mental well-being can influence group dynamics, collaboration, and participation in classroom activities, shaping the learning environment for everyone.

  • Academic performance: Student mental health significantly influences their academic performance. Challenges such as difficulty concentrating, retaining information, and completing assignments can hinder academic progress. Recognizing and addressing mental health concerns are crucial aspects of supporting students’ educational journey and ensuring their success in the classroom.

  • Long-Term Outcomes: Prioritizing student mental health can have long-term benefits for individuals and society as a whole. By investing in student mental health, educators contribute to building a healthier, happier, and more productive future generation. Students with good mental health are more likely to be productive, engaged learners and contribute positively to society, enhancing their future productivity and success.

Myths and facts about mental illness

There are myths and stigmatizations around mental health. Here are some myths and the respective real facts:

“Everyone who is sensitive or moody has mental health problems.”

Fact: Not everyone with mood-swings or who is crying easily has mental health problems. Everyone can have a bad day or temporary problems without having mental health problems. It also depends on the personality: Some people are a little more sensitive or impulsive than others. However, if such problems are extreme, last for a long period of time, havenegative consequences or affect the person, support should be sought.

“Only weak people can get mental health problems.”

Fact: Everyone can get mental health problems. A healthy lifestyle and coping strategies can reduce the risk.

“Mental health problems are just there without any early signs.”

Fact: There are early warning signs for mental health problems e.g. loss of appetite or sleep problems and it is important to notice them.

“Once someone is mentally ill they will never become healthy again.”

Fact: A Person can recover (gradually) or stabilize the situation with psychotherapy, medication or support. But even if someone can’t recover completely, they can develop strategies and learn to live with it.

“Ordinary People can’t do anything to help a person with mental health problems.”

Fact: Support and acceptance of the social environment is very important for people with mental health problems. Family, friends or teachers can also be an important part of the psychotherapy.

What types of mental health problems are there?

In the module "Mental Health Awareness", you could learn more about mental distress, mental health problems and mental illnesses.

Mental illnesses are clinically significant and persistent disturbances in cognition, emotions, physical health or behavior causing distress of impairment in important areas of functioning. These must be diagnosed by trained health professionals using established criteria and require evidence-based treatments.

If a teacher is concerned about their student mental health, he or she should make their concerns known to the person in the school most responsible for the assessment of the student’s health state like school psychologists or school workers.

There are different types of mental illnesses. There are categories to which each disease belongs:

Depression

Depression is characterized by persistent feelings of low mood that endure for an extended period, typically at least two weeks for diagnosis, significantly impacting daily functioning. Common symptoms include hopelessness, despair, guilt, worthlessness, fatigue, and lack of motivation. In severe cases, suicidal thoughts may arise, posing a serious threat to life. Depression can detrimentally affect self-esteem, sleep patterns, appetite, and physical health, impairing various aspects of a student’s life. Even in its mildest form, depression can make daily tasks more challenging, though it may not entirely disrupt normal functioning.

In adolescents, identifying depression can be challenging as they may exhibit different early signs compared to adults. For instance, irritability, changes in sleep patterns, social withdrawal, changes in appetite or physical complaints.

Students may appear withdrawn, frequently tired, have trouble concentrating, or show excessive worry and avoidance of certain situations or activities.

Bipolar disorder

Bipolar disorder, formerly known as manic depression, primarily influences mood. Those diagnosed often experience manic or hypomanic episodes (feeling high), depressive episodes (feeling low), and potentially some psychotic symptoms. While everyone experiences mood fluctuations, those with bipolar disorder may find these swings to be extremely intense, significantly affecting their daily lives. Periods of stability with fewer symptoms may occur in between episodes.

Students may show extreme mood swings, from high energy, talkativeness, and overconfidence to deep sadness, lethargy, and hopelessness.

Anxiety is the sensation of worry, tension, or fear, often arising in anticipation of future events or perceived threats. Occasional anxiety is a normal part of human experience. However, intense or prolonged feelings of anxiety can become overwhelming and may be accompanied by physical symptoms such as sleep disturbances and panic attacks.

Specific anxiety disorders, including generalized anxiety disorder (GAD), social anxiety (social phobia), panic disorder, or post-traumatic stress disorder (PTSD), Obsessive-compulsive disorder (OCD), may be diagnosed based on the nature and severity of symptoms. Nevertheless, individuals can also experience significant anxiety-related difficulties without a specific diagnosis.

Students may show signs of constant worry, restlessness, or avoidance of certain situations. They might appear withdrawn, tired, or struggle to concentrate due to heightened anxiety.
Obsessive-compulsive disorder (OCD) is classified as an anxiety disorder. Despite its misuse in everyday language to describe a penchant for neatness or tidiness, the disorder’s reality is significantly more intricate and severe. OCD is characterized by two primary components: obsessions, intrusive thoughts, images, urges, worries, or doubts that persistently intrude upon the mind; and compulsions, repetitive behaviors undertaken to alleviate the anxiety induced by these obsessions. Common obsessions include fears of contamination, concerns about harm to oneself or others, and intrusive thoughts of causing harm.
Students might exhibit repetitive behaviors or rituals, such as hand-washing or checking, performing tasks a specific number of times, or seek reassurance to alleviate doubts, and may be highly distressed if unable to complete these rituals.

Psychotic disorders encompass severe mental illnesses typically emerging during adolescence, characterized by a loss of contact with reality. During psychotic episodes, individuals may struggle to distinguish between what is real and what is not, experiencing disruptions in thoughts, perceptions, emotions, and behavior (e.g. not wanting to look at yourself, avoiding people, feeling disconnected…), leading to distress.

The apparition of symptoms is called psychotic episode and includes false beliefs (delusions) and sensory experiences (hallucinations), along with incoherent speech and inappropriate behavior. Psychotic symptoms can also appear in isolation or in a short and timely manner in other mental illnesses. The most common disorder in this category is schizophrenia.

Students might experience hallucinations or delusions, leading to unusual behavior, difficulty distinguishing reality from fantasy, or appearing disconnected from the classroom environment.

Neurodevelopmental disorders encompass conditions that affect brain growth and development. Examples include ADHD, ASD, communication disorders, intellectual developmental disorder, motor disorders, and specific learning disorders. These disorders can impact language, emotions, behavior, self-control, learning, and memory. Symptoms often emerge early in a child’s development, potentially persisting throughout life. Individuals with these disorders may face challenges in social and academic functioning, and they are at risk of developing comorbid conditions like depression or anxiety, particularly as they face increasing demands and stressors in life.
Students might have difficulty with social interactions, communication, or show repetitive behaviors, as seen in autism spectrum disorder, or have attention deficits and hyperactivity, as seen in ADHD.

Personality disorders are mental health conditions marked by persistent challenges in attitudes, beliefs, and behaviors, causing longstanding difficulties in various aspects of life. While not fundamentally different from others, those diagnosed may struggle with self-perception and relationships, finding it hard to change these patterns. The diagnosis is controversial, with some psychiatrists questioning its usefulness, and many individuals preferring alternative explanations for their experiences.
Students might have trouble forming stable relationships, exhibit extreme reactions to perceived criticism, or show consistent patterns of behavior that deviate markedly from societal expectations.

Eating problems extend beyond food and often involve challenging emotions and unresolved issues. Contrary to common belief, these problems are not solely characterized by being over or underweight; anyone, regardless of age, gender, or weight, can be affected. The most prevalent eating disorder diagnoses include anorexia, bulimia, binge eating disorder, and other specified feeding or eating disorders (OSFED). However, individuals may also struggle with food without meeting the criteria for a specific diagnosis.
Students might have noticeable changes in eating habits, appear overly concerned with body image, or show physical signs such as significant weight loss or gain, fatigue, or frequent trips to the bathroom after meals.
There are different degrees of severity, and one person can also have several mental health problems. That is called comorbidity.

The role of teachers

In the eSano module "Mental Health Awareness" on the intervention platform, you can learn the steps to follow in case you are concerned about one of your student’s mental health.

Please note that identifying a particular symptom of a mental illness in a student does not necessarily mean they have the illness. However, if the symptom persists and severely impacts their daily life, appropriate referrals should be made.

Similarly, if there is a need to safeguard students (e.g., self-harm, suicidal ideation, signs of abuse), please follow the appropriate local protocols. It is vital to communicate the situation to the school’s management and counselling team and to reach out to the student’s family immediately.

In the module "Effective Communication Strategies for Teachers", you will find more tips on addressing these situations, providing support, listening empathetically, and ensuring the safety of young people Here we will focus in giving some advice of what to do in case you are aware some of your students have mental health problems.

If you’re looking for ways to foster resilience and a positive learning attitude in your students, check out the eSano module "Cultivating a Growth Mindset in Students". It offers practical techniques to help students embrace challenges and develop a love for learning.

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Other ways to support Student’s Mental Health

In addition to referring students to appropriate professionals, here are some suggestions to enhance and promote their mental health.

  1. Create a Supportive Environment: Foster a classroom atmosphere where students feel safe and comfortable discussing their feelings and concerns.

  2. Encourage Open Communication: Encourage students to talk about their feelings and experiences and be an active listener when they do. Offer reassurance and support without judgment.

  3. Offer Resources: Provide students with information about mental health resources available within the school or community, such as counselling services, support groups, or hotlines.

  4. Be Flexible: Be willing to accommodate students’ needs related to their mental health, such as providing extra time for assignments or allowing for breaks during stressful periods.

  5. Collaborate with Parents/Guardians: Maintain open communication with students’ parents or guardians, sharing any concerns you have and working together to support the student’s well-being.

  6. Promote Self-Care: By promoting self-care practices, such as relaxation techniques, mindfulness exercises, and healthy coping strategies, you can teach students the importance of taking care of their mental well-being. Modelling healthy coping strategies can be particularly effective in demonstrating these practices to students.

There are several things you can do for normalizing mental health in the classroom. As you may have learned in the social and emotional learning module, modeling can help teach students and promote a school environment where mental health is openly discussed, understood, and supported, making it easier for students to seek help and manage their own well-being.

1. Discussing Emotions: Encourage open dialogue about emotions, promoting respect and empathy towards diverse feelings. Identifying the stimulus that triggered the emotion, naming the emotion, and trying to understand why it provoked that emotion. We must understand that each person interprets reality differently, generating completely valid emotions. This involves promoting respect and empathy towards all emotions and, if necessary, helping to manage them appropriately. 

2. Talking about How We Feel About Ourselves - a step towards being a good role model for students. Model self-awareness and positive self-perception to set an example for students.

3. Highlighting the Value of Seeking Support: Emphasize the importance of seeking assistance when needed, highlighting the role of mental health professionals.

4. Cultivating Conscious Language Use: be conscious of language regarding mental health to challenge stereotypes and reduce stigma.

Key ideas of mental health for teachers

  1. Prioritizing the mental health of young people benefits not only their well-being now but also the future of the country and its citizens, as fostering good mental health can prevent issues from persisting into adulthood. It is concerning that approximately 14% of young people experience mental health problems, a figure that has been increasing since 2019, according to the WHO.

  2. Any significant change in students’ behaviour, such as arriving to class sleepy, not eating, vomiting, or feeling dizzy, could indicate an underlying emotional issue that needs to be addressed.

  3. Persistent feelings of sadness, extreme irritability, or self-harming behaviors can be signs of an emotional problem that requires attention.

  4. Both a lack of interaction and hyperactivity in children can be indicative of emotional difficulties that need to be addressed.

  5. It is crucial to facilitate students’ expression of their feelings and concerns without interpreting or minimizing them, fostering an environment of freedom and trust.

  6. If we are aware that a student is suffering from a mental health problem, it is important to collaborate both with mental health services and families to promote their wellbeing.