Dáil debate on the need for stigma-reduction education

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See Change welcomes the debate on the need for stigma-reduction education in secondary schools in the Dáil as raised by Simon Harris, TD.

Research and international practise[i]show that school children are another key target for anti-stigma interventions. Stigmatising attitudes and ideas are attained over a lifetime and evidence suggests that these attitudes are established in childhood.[ii] Children and adolescents can also be the victims of stigmatising attitudes. Young people experiencing mental health problems are also at risk of face same rejection, damage to self esteem and reluctance to seek support as adults.

Here’s the transcript of yesterday’s (Wednesday, 16 November 2011) topical issue debate on ‘Mental Health Awareness:

Deputy Simon Harris: I welcome the opportunity afforded to me by this debate to highlight the need for stigma-reducing and mental health education in Irish schools. As a country we must ensure that our children and young people leave schools with the tools they need to look after their mental health and the knowledge that there is no shame in discussing mental health or in looking for help from the various professionals best placed to provide it.

I welcome the commitment of the Government to continue to invest in our mental health services and to implement the recommendations of A Vision for Change. As we work to establish more community-based mental health services, a great deal has been made of the need to break down the stigma surrounding mental health issues in our society. We must work to prevent new stigmas from forming as well. Young people experiencing mental health problems are at exactly the same, if not a greater, risk of rejection, damage to self-esteem and a reluctance to seek support as their adult counterparts. It is vital that we do everything we can to introduce children in an age-appropriate fashion to positive mental health education and stigma-reducing programmes.

I have spoken in the House previously about the contrast between the way we teach children about their mental health and the way they learn about the basics of dental health. We teach our children from the youngest age in schools about the damage that sweets and fizzy drinks can do to their teeth. We teach them how to prevent dental problems. We discuss the tools they need and the importance of brushing their teeth morning and night. We discuss the need for regular visits and check-ups and the fact that there is no shame in a toothache. We should use our schools to teach children the fundamental tools they will need to look after their mental health using exactly the same method we use to teach them how to protect and mind aspects of their physical health.

We can learn from our international colleagues and neighbours on this issue. For example, in Scotland, following a successful two-year pilot programme, the positive mental health attitudes curriculum has been adopted by the education department. Children are given the opportunity to engage with mental health in the classroom and to discuss issues that may affect them with their teachers and peers. Since this is now a national curriculum, teachers have been provided with lesson suggestions, worksheets and a DVD of anecdotal scenarios to highlight mental health issues that young people and their friends and family members may be experiencing. At a basic level, the inclusion of this subject as part of a national curriculum would ensure that all children receive the same message on mental health from their school.

The answer I often receive from the Department of Education and Skills is that social, personal and health education is part of the junior cycle but this is not adequate. The subject touches on emotional well-being only in a broad sense. The reality is that one in four people in the country experience mental health difficulties at some stage in their lives. Their challenges have been kept behind closed doors for too long in this country and we have seen the negative consequences of this.

We must have a more specifically targeted programme to ensure young people leave school empowered with the tools required. This is nothing new and it is recommended in the Government’s policy, A Vision for Change. It is also recommended and fleshed out in some detail by See Change, the national mental health stigma reduction partnership. There should be a willingness to recognise that this is about more than simply resources when we are discussing mental health. It is about a culture and how we can knit the promotion of positive mental health throughout the schools. We have a captive audience sitting in classrooms throughout the island on a daily basis and we must ensure that teaching time and the classrooms are used as the powerful tools they can be to reduce stigma and to give people the tools to promote positive mental health.

Minister of State at the Department of Education and Skills (Deputy Ciarán Cannon): I take this topical issue debate on behalf of my colleague, the Minister for Education and Skills, Deputy Ruairí Quinn. I thank Deputy Harris for raising this important issue. Schools play a vital role in reducing the stigma surrounding mental health issues and mental health education features strongly in the curriculum.

The social, personal and health education, SPHE, programme has been a mandatory part of the curriculum in primary schools and in junior cycle since 2003 and is designed to promote positive mental health. It is supported by comprehensive teacher guidelines and curriculum support services which provide training and advice for schools and a resource directory. Its aim is to foster the personal development, health and well-being of children, to help them create and maintain supportive relationships and develop the skills and attitudes for responsible citizenship. It includes relationships and sexuality education. In addition, all schools are required to have an agreed school policy and a relationships and sexuality education, RSE, programme at senior cycle.

The curriculum at primary level includes such issues as self awareness; relationships and sexuality education, feelings and emotions, making decisions, relating to others, communications resolving conflict and dealing with bullying. These themes are continued at post primary level, where SPHE is presented in ten modules covering self management, communication skills, relationships and sexuality, belonging and integrating, emotional health and influences and decisions, physical health, substance use and personal safety.

SPHE is designed for implementation in the context of a caring whole-school approach, supported by the pastoral care structures in schools and good parental links. A report was published in 2009 based on inspection of SPHE in 40 primary schools. It showed many extremely positive findings, including high levels of satisfaction from parents that their children’s social and personal development were being promoted in schools, that their confidence and self esteem was supported and that they were encouraged to behave well and take responsibility for their actions.

Inspectors found in most classrooms pupils were encouraged to voice their opinions and interact positively with others. They displayed a good understanding of the SPHE content they had covered and considered themselves to be thoughtful about the feelings of others. Very high proportions of students considered themselves to be happy in schools and the report found feelings and emotions were addressed regularly in SPHE lessons.

All post-primary schools provide a guidance and counselling service for their students. The service includes the provision of individual guidance and counselling for students at critical stages in their education or times of personal crisis. Psychologists from my Department’s national educational psychological service, NEPS, are present in schools across the country and provide a range of supports. These include the promotion of positive mental health among the general student body and assistance in supporting pupils with particular social, emotional or behavioural difficulties. The NEPS also encourages the development of structures among teachers and schools care teams which link with the relevant local HSE mental health services. Schools are playing their part within the resources available to promote positive mental health among students.

Deputy Simon Harris:
I thank the Minister of State for his response. While I welcome the provision of SPHE within our school system it is limited. We recognised that as a country when we brought together partners working in this area from the sea change initiative and the Government policy A Vision for Change.

One of the issues with SPHE, apart from the fact that it is a broad subject, is that we need to examine how to tackle the issue of stigma and stigma reduction at a much younger age. There is an opportunity to build on a programme called Zippy’s Friends which is already delivered to primary school children in first and second class. We could consider rolling out scenarios in an age appropriate fashion. The problem is about stigma and culture.

It is not long ago, relative to others, since I was in primary and secondary school and it was not normal to see a child with special needs in school. As a country we have changed our attitude to special needs and disabilities. Mental health is the next big challenge for our education system and culture is a factor. I ask the Minister of Stage to revert to his officials and ask them to consider examining best practice in other places, particularly in regard to what I cited in Scotland.

It is clear that what we are doing is not working. While there might be positive steps we know as a country a huge body of work needs to be done in regard to mental health. I know the Government is committed and I am fully supportive of the measures it is taking in that regard but we have to think outside the box and realise that the days of giving the age old answer of SPHE as a solution is not enough. We have to go further than that.

The term “knitted” is important. The issue needs to be addressed across our curriculum and subjects. The language used by teachers and the environment of a school has to discuss on a regular basis the issues people are experiencing in their homes which for far too long were not discussed in this country. We have a huge opportunity to use our schools while educating students to tackle issues regarding culture and stigma. I urge the Minister of State to take the opportunity to do that.

Deputy Ciarán Cannon: I share many of the sentiments expressed by Deputy Harris. He is correct in saying that in the past a major stigma has been attached to mental health issues in this country and where better to address that than in our education system. In making our children more environmentally aware we have succeeded in making them the environmental wardens or lieutenants of our country through the green schools programme. We could achieve something similar in reducing the stigma associated with mental health problems.

The resource programme introduced in October 2010 entitled Working Things Out through SPHE was launched to support teachers in the delivery of the mental health promotion dimension of the SPHE programme. It demonstrates case studies of young people who have successfully managed a variety of difficulties, including bullying, bereavement, depression, easing problems, obsessive compulsive disorder and feelings of anger, fear and anxiety. Our response is beginning to happen, although I agree with Deputy Harris that one could never argue we have a perfect system in place.

It is always important to look abroad to best practice in other jurisdictions. I will undertake to work with my officials and if the Deputy submits more detail of the Scottish programme I could undertake to consider it. He is correct to point out that we need to, as he described it, knit this sort of provision across the whole school programme.

In this country we are providing literacy solutions to resolve literacy problems among our adult learners by incorporating literacy solutions into all of the further education provisions across a number of different courses and training provisions. We need to engender a cultural change which will bring the issue of mental health and the stigma associated with it in the past to the fore. If Deputy Harris wants to liaise directly with me, we could examine best practice abroad and determine how we can incorporate some aspects into a provision in the future.

 


[i] Scheff, T. (1999) Being mentally ill: A Sociological Theory. (3rd ed). New York: Aldine De Gruyter.

[ii] Wahl, O et al. (2011) Changing Knowledge and Attitudes with a Middle School Mental Health Education Curriculum. Stigma Research and Action, Vol 1, No 1, 44-53

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