Mental & Emotional Health

1. Mental & Emotional Health Lecture #7 CHS 485

2. Words such as: Hope, wisdom, creativity, courage, spirituality, and responsibility are all related to mental and emotional health.

3. Prevalence of Mental Health Problems

4. Prevalence of Mental Health Problems • Health experts have reported sharp declines in major infectious diseases and medical problems among young people during the past century. • In contrast, one in five children and adolescent may have a diagnosable mental health problem. • Mental disorders that affect children & adolescents: • Anxiety disorders • ADHD • Autism spectrum disorders • Bipolar disorder • Depression • Eating disorders • Childhood onset schizophrenia

5. Cost of Mental Health Problems • Mental health problems produce more impairment than almost any other condition among children and adolescents. • Treatment of mental health problems is expensive. • When left untreated, mental health disorders can lead to school failure, family conflicts, drug abuse, violence, and even suicide.

6. Mental & Emotional Health and Academic Performance • Adolescents miss more schools as a result of emotional and behavioral symptoms than for any other conditions. • Young people with mental health problems are more likely to drop out from school and fail than any other group of children with disabilities. • Mental health challenges that affect children learning and behavior at school: • Stress & anxiety • Worries about being bullied • Problems with family or friends • Disabilities • Depression • Concerns about sexuality • Academic difficulties • Substance abuse

7. Factors influence Mental & Emotional Health • Mental disorders appear in families of all social classes and all background. Yet some children at greater risk. • There is good evidence that both biological factors and adverse psychological experiences during childhood influence. Adverse experiences can occur at home, at school, or in the environment. • The root of most mental disorders lie in some combination of biological and environmental factors.

8. Factors influence Mental & Emotional Health Risk Factors • Risk factors are characteristics, variables, or hazards that if present for a given individual, make it more likely that the individual will develop a disorder. • Risk factors are not static but change in relation to a developmental phase or a new stressor. • Low birth weight • Unsatisfactory relationships • Parental mental health disorder • External risk factors such as poverty, deprivation, abuse and neglect • Exposure traumatic events

9. Children of a depressed parent are four times more likely than other children to develop an affective/ psychological disorder due to both genetic and other environmental factors.

10. Factors influence Mental & Emotional Health Protective Factors • Protective factors improve response to some environmental hazards. • The construct of resilience which focuses on the ability of an individual to withstand chronic stress or recover from traumatic life events. • Environmental Protective Factors • Social Protective Factors • Individual Protective Factors

11. Social Protective Factors Environmental Protective Factors Individualized Protective Factors - Value for school & academic achievement. - Sense of support & belief in a positive future. - Critical thinking & problem solving skills. - Emotional resilience & ability to manage feelings. - Family support and connectedness. - Parental monitoring - Attachment to prosocial peers. - Connectedness to school. -Community recognition of young people’s values. -Schools with high academic standards & low dropout rates. -Research proven health curricula. Protective Factors

12. Discussion What are the topics & considerations needed for teachers to provide a mentally & emotionally healthy classroom environment??

13. Guidelines For School To Promote Mental & emotional Health • Creating safe and caring classroom communities. - FourTribes community agreements developed by Jeanne Gibbs1. Attentive listening2. Appreciation / no put downs3. The right to pass4. Mutual respect- Teaching children to feel empathy & value relationships

14. Guidelines For School To Promote Mental & emotional Health • Examining self-esteem • Fostering resilience: helping students use their minds & hearts well. • Recognizing and helping students who have problems. • Teachers need to know where to go to find valid & reliable information on specific health problems

15. Guidelines For School To Promote Mental & emotional Health • Public health professionals can encourage youngsters and their families to take advantage of opportunities in the schools and community to prevent problems and enhance protective buffers. Examples include enrollment in:(1) Direct instruction designed to enhance specific areas of knowledge, skills, and attitudes on mental health matters.(2) Enrichment programs and service learning opportunities at school and/or in the community. (3) after-school youth development programs.

16. Guidelines For School To Promote Mental & emotional Health education The module uses the National Health Education Standards as the framework for determining the content of a curriculum to enable students to master the essential knowledge and skills that promote mental and emotional health.

17. Developmentally Appropriate Knowledge & Skills Expectations Knowledge Expectations : NHES 1 : Core Concepts 11. Identify characteristics of someone who has self-control. 12. Identify feelings of depression & sadness. 13. Describe how people are similar and different. 14. Explain the interrelationship of physical, mental, emotional, social, and spiritual health. 15. Describe how mental and emotional health can affect health related behaviors. 16. Describe what it means to be a responsible person. 17. Describe ways to manage interpersonalconflict nonviolently. 18. Explain causes, symptoms, and effects of anxiety. 19. Describe personal stressors at home, in school, and with friends. 20. Explain causes, symptoms, and consequences of common eating disorders. 21. Explain causes, symptoms, and effects of depression. 22. Analyze the risks of impulsive behaviors. 1. Explain the importance of talking with parents & other trusted adults about feelings. 2. Explain the relationship between feelings & behaviors.3. Identify the benefits healthy family & healthy peer relationships. 4. Explain the importance of personal space & boundaries of others. 5. Identify characteristics of a mentally & emotionally healthy person. 6. Identify role models who demonstrate positive emotional health. 7. Describe healthy ways to express affection, love, friendship, and concern. 8. Identify positive & negative ways of dealing with stress & anxiety. 9. Give examples of prosocial behaviors: helping others, being respectful of others, cooperation) 10. Identifypersonal stressors at home, in school, and with friends.

18. Developmentally Appropriate Knowledge & Skills Expectations Skills Expectations: NHES 2 : Analyze influences 1. Identify relevant influences of family on mental and emotional health practices. 2. Identify relevant influences of school on mental and emotional health practices. 3. Identify relevant influences of media & technology on mental and emotional health practices. 4. Describe positive influences on mental and emotional health practices. 5. Describe negative influences on mental and emotional health practices. 6. Identify relevant influences of culture on mental and emotional health practices. 7. Identify relevant influences of peers on mental and emotional health practices. 8. Identify relevant influences of community on mental and emotional health practices. 9. Explain the influences of school rules & community laws on mental and emotional health practices. 10. Explain how perception of norms influence healthy & unhealthy health behaviors. 11. Explain how social expectations influence healthy & unhealthy health behaviors. 12. Explain how personal values & beliefs influence healthy & unhealthy health behaviors.

19. Developmentally Appropriate Knowledge & Skills Expectations Skills Expectations: NHES 3 : Accessing information, products, & services 1. Identify trusted adults at home who can help promote mental & emotional health. 2. Identify professionals in school who can help promote mental & emotional health. 3. Identify professionals in the community who can help promote mental & emotional health. 4. Describe characteristics of accurate, reliable and trustworthy mental & emotional health information. 5. Demonstrate how to locate sources of accurate mental & emotional health information. 6. Analyze the validity and reliability of mental & emotional health information/ products and services. 7. Access valid and reliable mental & emotional health information from home, school or community.

20. Developmentally Appropriate Knowledge & Skills Expectations Skills Expectations: NHES 4 : Interpersonal Communication 1. Demonstrate how to effectively communicate needs, wants, and feelings in healthy ways. 2. Demonstrate effective active listening skills: pay attention, verbal & nonverbal feedback. 3. Demonstrate effective refusal skills to avoid participating in emotionally unhealthy behaviors. 4. Demonstrate how to effectively tell a trusted adult when feeling threatened or harmed. 5. Demonstrate effective verbal and nonverbal communication skills. 6. Explain how to empathetic and compassionate toward others. 7. Demonstrate effective peer resistance skills to avoid or reduce mental & emotional health. 8. Demonstrate healthy ways to manage or resolve interpersonal conflict. 9. Demonstrate effective negotiation skills to avoid or reduce mental & emotional health.

21. Developmentally Appropriate Knowledge & Skills Expectations Skills Expectations : NHES 5 : Decision Making 1. Identify situations that need a decision related to mental & emotional health: dealing with interpersonal conflict, managing anger. 3. Explain the potential positive & negative outcomes from decision related to mental health. 4. Explain how family, culture, peers, or media influence a decision related to mental & emotional health. 5. Identify options and their potential outcomes when making a decision. 6. Choose a healthy option. 7. Describe the final outcome of a decision. 8. Distinguish between health & unhealthy alternatives of a mental & emotional health related decisions. 9. Predict the potential outcomes of healthy & unhealthy alternatives. 10. Analyze the effectiveness of a final outcome of a mental and emotional health related decisions.

22. Skills Expectations : NHES 6 : Goal Setting Developmentally Appropriate Knowledge & Skills Expectations 1. Identify a realistic personal short-term goal to improve or maintain positive mental health. 2. Take steps to achieve the goal to improve or maintain positive mental & emotional health. 3. Identify people who can help achieve a goal to improve or maintain a positive mental & emotional health. 4. Set a realistic long termgoal to improve or maintain positive mental & emotional health. 5. Identify resources that can help achieve a goal to improve or maintain positive mental & emotional health. 6. Assess personal mental & emotional health practices. 7. Assess the barriers to achieving a goal. 8. Applystrategies to overcomebarriers to achieving a goal.

23. Developmentally Appropriate Knowledge & Skills Expectations Skills Expectations : NHES 7 : Self- Management 1. Identify mental & emotional health practices that reduce or prevent health risks. 2. Demonstrate healthy mental & emotional health practices. 3. Make a commitment to practice healthy mental & emotional health behaviors.

24. Developmentally Appropriate Knowledge & Skills Expectations Skills Expectations : NHES 8 : Advocacy 1. Make requests to others to promote personal mental & emotional health practices. 2. Demonstrate how to encourage peers to make healthy mental & emotional health choices. 3. Give factual information to improve the mental & emotional health of others. 4. State personal beliefs to improve the mental & emotional health of others. 5. Demonstrate how to persuade others to make positive mental & emotional health choices. 6. State health enhancing position on a mental & emotional health topic, supported with accurate information to improve the health of others. 7. Persuade others to make positive mental & emotional health choices. 8. Collaborate with others to advocate for improving mental & emotional health of individuals, families, and schools.

25. Addressing Sexual Health In Schools - Sexual health as defined by the World Health Organization (WHO) is “… a state of physical, emotional, mental and social well-being in relation to sexuality...” (WHO, 2015, pp. 5)

26. Sexual Health in Schools - Suggesting a whole child approach to sexual health education and not merely the absence of unplanned pregnancy or sexually transmitted infections. “Effective sexual health education recognizes that responsible individuals may choose a variety of paths to achieve sexual health” Educational programs that withhold information necessary for individuals to make voluntary, informed decisions about their sexual health are unethical .(World Association for Sexology, 2008).

27. What values are taught in school-based sexual health education? • Focuses on the self-worth, respect and dignity of the individual. • Is provided in an age-appropriate, culturally sensitive manner that is respectful of individual sexual diversity, abilities, and choices. • Helps individuals to become more sensitive and aware of the impact their behaviours and actions may have on others and society. • Does not discriminate on the basis of age, race, ethnicity, gender identity, sexual orientation, socioeconomic background, physical/cognitive abilities and religious background in terms of access to relevant, appropriate, accurate and comprehensive information.

28. Sexual Health & Academic Achievement - Sexual behaviors among teens often takes a particular toll on school connectedness for both partners, representing a major disruption in many teens’ lives and making it difficult to remain in and/or engaged in school. - Pregnant and parenting teens have lower grades and higher dropout rates than their non-parenting peers. In fact, research shows that only 51 percent of pregnant and parenting teens graduate from high school as compared to 89 percent of their non-pregnant and parenting peers.

29. In the area of sexual health education, policies often state whether: - Sexuality or HIV education is required, how it is providedand who is providing it, the role of parents and course content.- With access to services, including information as to when, how and by whom referrals are made. Aim to: improving knowledge and skill-building to help students maintain and improve their sexual health by delaying sexual initiation, reducing sexual health-related risk behaviors, and preventing disease and pregnancy.

30. The key ingredients of effective sexual health promotion programming 2.Sexual health education should be presented by confident, well-trained, knowledgeable and nonjudgmental individuals who receive strong administrative support” 1. A realistic and sufficient allocation of classroom time to achieve program objectives. 3. Employ sound teaching methods including the utilization of well-tested theoretical models to develop and implement programming (e.g., IMB Model, Social Cognitive Theory, Transtheoretical Model, Theory of Reasoned Action/Theory of Planned Behaviour). 4. Use elicitation research to identify student characteristics, needs, and optimal learning styles including tailoring instruction to student’s ethnocultural background, sexual orientation, and developmental stage.

31. The key ingredients of effective sexual health promotion programming 5. Specifically target the behaviours that lead to negative sexual health outcomes such as STI/HIV infection and unintended pregnancy. 6. Deliver and consistently reinforce prevention messages related to sexual limit-setting (e.g., delaying first intercourse; choosing not to have intercourse, consistent condom use and other forms of contraception) 7. Include program activities that address the individual’s environment and social context including peer and partner pressures related to adolescent sexuality. 8. Provide clear examples of and opportunities to practice (e.g., role plays) sexual limit setting, condom use negotiation, and other communication skills so that students are active participants in the program, not passive recipients. Refusal skills)

32. Key ingredients of behaviourally effective sexual health education programs - Sexual Health Education Program should be based and structured on theoretical models of behaviour change that enable educators to understand and influence sexual health behaviour. - Motivation-Behavioural Skills (IMB) model of sexual health enhancement and problem prevention; For information on the use of the IMB model for the planning, implementation, and evaluation of sexual health education programs, For example, the IMB model specifies that in order for sexual health education to be effective 1. it must provide information that is directly relevant to sexual health (e.g., information on effective forms of birth control and where to access them), 2. address motivational factors that influence sexual health behaviour (e.g., discussion of social pressures on youth to become sexually active and benefits of delaying first intercourse), 3. teach the specific behavioural skills that are needed to protect and enhance sexual health (e.g., learning to negotiate condom use and/or sexual limit setting).

34. PARENTAL RIGHTS AND INVOLVEMENT Parents and guardians are critical partners in education, especially sexual health education. As such, parents are typically notified when sexual health education will occur, informed about what course material will be provided, and given the opportunity to review curricula and to excuse their child from instruction without penalty for all or part of the instruction.

35. Sexual and Reproductive Health Services • Teens report many barriers to accessing sexual and reproductive health services (e.g., STD/HIV testing, Pap tests and pelvic exams, pregnancy testing) including accessibility (i.e., inconvenient clinic hours, transportation, confidentiality and cost). • School nurses / health educators;, in compliance with board policy may: • Provide medically accurate information and resources to students and staff; • Provide referrals and counseling relative to pregnancy, STD and HIV testing; • Provide counseling to pregnant teens, or teens who think they might be pregnant.

36. Bullying and Harassment Bullyingrefers to any behaviour creates a risk to health and safety.Harassmentcovers a wide range of behaviors of an offensive nature. Including abusive words, comment and physical touches & practices. Bullying and harassment are of growing concern in schools. Technology has complicated schools’ ability to identify and promptly address bullying, harassment and relationship violence. However, there is a growing movement within schools to proactively create safe, supportive school environments.

37. Extra Shots References • Telljohann, Susan Kay, Cynthia Wolford Symons, and Beth Pateman. (2001) Health education: Elementary and middle school applications.New York: McGraw-Hill. Chapter 2 and 3. • The Centre of Disease Control (CDC) * Action for healthy kids: http://www.actionforhealthykids.org • Journal of School Health. Suggested Readings - Sexual Health Education * http://sieccan.org/wp-content/uploads/2018/05/SIECCAN_Q-A-Sexual-health-education-in-the-schools.pdf http://advocatesforyouth.org/storage/advfy/documents/addressing%20sexual%20health%20in%20schools-%20policy%20considerations.pdf

38. Best! “ Your mental health is a priority. Your happiness is an essential. Your self-care is a necessity.”“ — Wayne Dyer.