Supporting needs within the borough
Our interactive workbook supports needs in the borough, addressing specific elements of the 15“0-19 Children's Needs Assessment” on “social and emotional wellbeing” and “mental health”. The information here also refers to the “key themes and recommendations” using statistics presented under “estimated prevalence”.
The importance of supporting parents, children, young people, and communities is stated in Harrow Council’s 15JSNA, under the “Start well” aspect. Objectives like “emotional wellbeing” and the “capacity to form and maintain positive relationships with others”, defined in “Start Well: Giving every child the best start in life” are outcomes our workbook can support. We support the human interaction and relationships between adults/carers/professionals and children, facilitating discussion about feelings and emotions to build stable, loving relationships based on trust and confidence, to support the child.
Roxy’s interactive workbook can offer schools a means to encourage children's social and emotional wellbeing. Whether it is used in a home setting with parents, SEN resource or school counsellors’ tool, normalising a space where children can disclose their emotions and feelings. Being able to talk is the one single most accessible way to relieve symptoms of mental ill-health. We are not targeting specifically children in need but for all children using this workbook to benefit by realising greater awareness of mental health, reduce stigma and increased resilience. Also, the book provides an effective way to measure activity and changes/improvement.
Used as a tool for school nurses, the workbook gives as an opportunity to subtly counter challenging behaviour. Combining the exercises and experiences of the characters to empathise, helps to support the child’s emotional wellbeing. The talking exercises, at the end of every chapter, provide the means to explore empathy and guided questions provide openings in the interaction, for the adult and/or child to disclose their experiences and coping strategies. Further support for emotional literacy is provided with an emotional glossary, useful for children with SEN or language difficulties. They can look up the meanings of the emotional and feeling words utilised throughout the chapters.
21This workbook supports the NICE guidance and children’s needs assessment under “11.10.1 SOCIAL AND EMOTIONAL WELLBEING”. i.e.
• The empathic understanding gained by the child can support positive behaviours for learning and successful relationships.
• Providing an emotionally secure and safe environment that prevents any form of bullying or violence.
• Supporting all pupils and, where appropriate, their parents or carers (including adults with responsibility for looked after children).
• Providing specific help for those children most at risk (or already showing signs) of social, emotional, and behavioural problems.
• Offering teachers and practitioners in schools training and support on how to develop children's social, emotional, and psychological wellbeing.
To support of the 15“12.1KEY THEMES AND RECOMMENDATIONS”, the action plan space, after the questions at the end of each chapter, allow adults or children to create and document follow-up tasks if any information is disclosed in the exercises. This work is an early intervention which can be used as evidence and shared between professionals.
“Key themes from the consultations”
The workbook provides a documented snapshot of a child’s emotional wellbeing and visibility of interaction. 16This is an opportunity to contribute to the safeguarding of children in need, a growing trend in Harrow. The workbook can be used at an assessment allowing the parent/carer to evidence the case and can act as a buffer when there is a low capacity from the local authority. There is a direct relationship between mental and physical health, both are equally important. The workbook has a nine-question survey to identify a baseline regarding mental health awareness, stigma and resilience. We have the same survey at the end, in the book, so we can score the surveys, understanding where our baseline is and measure improvement or change. This is PSHE education taught away from school using the experience of the adult/parent/carer to support the child.
“Key health concerns”
Roxy’s interactive workbook addresses the key health concern, 21“Mental health especially bullying shifted to digital, support to special educational needs and disabilities”. Whilst not specifically targeting disabilities, disability is a strong risk factor for mental health difficulties.
CAMHS are invaluable and have established support from existing services. CAMHS will continue to be overstretched because mental health is part of everyone’s lives and education is an uphill battle. This is due to the stigma still having a strong influence on society. What we put into our minds will influence and determine our life path. This is especially important for children who need protecting from dangers not previously experienced by today’s adults. There are existing services provided to manage the increase in mental health referrals, “putting out the fire” created by social media and other influences. This workbook is designed for children 7-11yrs but can be used as low as 5yrs old, depending on the age and stage of development. It is targeting pre-transition children before they are influenced by the grip of peers and social media.
In my experience and understanding of mental health, education regarding mental health must be at an early stage where children are still “pliable”, so we can engage and share tools to support them later in life. We can provide strategies but most importantly, we create a space where they can talk about their feelings and emotions. This is a safe psychological space the child can return to when they need to talk, instead of acting out with bad coping strategies like self-harm. This education is not only for children in need but for all children. We do not need to wait for illness, this is early prevention that supports and complements the local authority’s existing strategy.
Key health promotion messages:
Emotional wellbeing is a key promotion message. Diagnosing mental or emotional health is unfortunately as simple as taking a temperature reading, it is time-consuming. With growing concern regarding the capacity of health visitors and school nurses, the undeniable increasing trend of mental and emotional wellbeing in children will be harder to maintain. This workbook is a tool which allows us to establish markers relating to mental health awareness, stigma and resilience for children for education at home. It is not a quick fix but an evidenced snapshot, worked on at home (for most children) to identify their need for support. It will not fit all scenarios but the majority to promote emotional wellbeing for children and parenting skills protecting families.
21In response to “7.7 MENTAL HEALTH” the report states, “Good mental health starts in infancy and research shows that a baby who doesn't get to feel a healthy bond with a parent is at much higher risk of developing mental health problems than a child with a strong connection to the person who cares for them”.
Rises in child and adolescent mental health disorders are common. 24The NHS Digital Report, “Mental Health of Children and Young People in England 2017” indicates, “9.5% of 5-10 year olds had at least one mental health disorder.”
Apart from instances of depression and anxiety, the most significant problems faced by children and society, there is a concerning growing trend of self-harm. Regarding self-harm, the Harrow 150-19 Children's Needs Assessment states, “This is a very common problem among young people. Some people find it helps them manage intense emotional pain if they harm themselves, through cutting or burning, for example. They may not wish to take their own life.” The long-term damage that can be caused by unpredictable results of self-harm can be life changing. This is effectively a bad coping strategy which is becoming a norm due to poor communication about the child’s feelings of inferiority.
To quote the report: “Self-harming in young people is not uncommon (10–13% of 15–16-year-olds have self-harmed) but only a fraction of cases are seen in hospital settings.”
For us, this is the greatest danger, for children to suffer secretly and in silence. It’s a common poor coping strategy. This workbook is designed to avoid secrecy and silence when it comes to emotions and feelings. Mental health awareness, reduced stigma and resilience are the keys and why we produced the workbook. It is the single most effective means to alleviate the longer-term symptoms of poor mental health in society.
Education is provided through disclosures of the child and adult we can prevent or support conditions which could otherwise have a detrimental effect on children as they get older.
The growing trend of ill mental health in children is documented in the report. “One in ten children aged between 5 and 16 years has a clinically diagnosable mental health problem. About half of these (5.8%) have a conduct disorder, 3.7% an emotional disorder (anxiety, depression) and 1–2% severe Attention Deficit Hyperactivity Disorder (ADHD)15.
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The impact is unmistakable and shows future problems with health, education, social outcomes, suicide, and crime. The workbook is aimed at children to prevent them from falling foul of challenging issues later in life.
The estimated prevalence of mental health disorders in children and young people in harrow, carried out in 2004 into mental health prevalence show 3,171 children and young people aged 5-16 who have any mental health problem.