Mental Un-health?

Firstly, I feel I need to make some kind of disclaimer to make it clear that what I've written here is in no way intended to offend or upset anyone. I've been sitting on this blog for a couple of months now as the topic is a sensitive one and I've been unsure how well it will be received. It may seem that each paragraph swings between opposing viewpoints and that's because I have no idea what the right outcome should be. I’m not here to give answers as I don’t have them but I have had many conversations over the last few months that I feel could raise useful and important discussions. What I have written is based on personal experiences, my own observations and those made by colleagues and other parents.

During my time as a school nurse it has been impossible to ignore how many children seem to be suffering with mental health issues. Stress, anxiety and depression are rife among all year groups and there are days when I wonder if there is a child in existence who is growing up feeling secure in themselves. We all know that the teenage years are difficult. Body changes, body image, independence for the first time, increased school work, exams and, for our current kids, a year of lockdowns doesn’t make for an easy ride. But for generations people have been dealing with these changes so why is mental health such a hot topic now? Is it simply because we talk about it more or is it because our children are becoming less and less resilient?

I had a conversation with another school nurse recently about this as we have noticed, particularly in the younger years of senior school, an increased level of mental health needs. I was fascinated by her opinion that resilience is now almost seen as a negative. Her impression is that children are taught to talk about every feeling, thought and emotion but are not encouraged to develop coping strategies to make it through the day. She believes that coping is now seen as a way of merely masking problems. But is it always? I could see her point of view. Absolutely there are children truly suffering and some who have had the most awful childhoods imaginable. However, I believe there are many who are just having what we used to call ‘a bad day’. The kind of day that a bubble bath or your favourite chocolate in front of Friends used to remedy.

If you’ve read my blog County Lines you’ll know that my son has had a terrible few months and we have, of course, encouraged him to talk about everything that has happened. We have also accepted all support on offer from the school and community health team so that he has had every opportunity to process the experience. But we have also discussed his feelings as being a direct response to the threatening behaviour he was a victim of. While of course he will feel low about it, he does not have depression. Over the last month I have seen his mood dramatically improve now that the ordeal is over. He is more applied at school, is spending time creatively and positively and building healthy new friendships. He has learned from the experience and his mistakes and has admitted that talking to me feels like a weight of his chest. So yes, it’s obviously great to talk but I feel it’s important not to dwell too much but rather look for the positives and see this as a time of progression to help him to move past it. Because although six months of a bad experience seems long at the time, it’s a tiny fragment of his whole life.

I’ve written before about my fondness for the children I care for as a school nurse. I have met some I’d like to do so much more for - those who have a difficult past or present and who haven’t had enough care along the way. The effects of this are prevalent in many ways from behaviour, to confidence and school achievements and so much more. But what interests me from my own observations is that the children who have had the worst backgrounds are often the most resilient. These children frequently come to have a chat with me to unload but are usually determined to stay in school. Somehow they have been shaped by what they’ve been through and are looking towards their future. I am blown away by their attitude and can only admire their perseverance. So why is it then that so many other children attend my medical room every day in an attempt to be sent home?

I frequently see over 60 children a day. That’s about 5% of the entire school population on a daily basis and I’d say only a quarter of the children I deal with are genuine. The rest present with all manner of ailments, including anxiety, but don’t actually display true symptoms of these. I hear them laughing and chatting to their friends while they’re waiting to see me but as soon as they enter my medical room they sink into a suppressed and melancholy state and barely manage to mumble a word to me. They come to see me with the hope that I will send them straight home or, at worst, that I will let them see out their least favourite lesson hiding in the medical room. I’ve started to wonder – and I know this is controversial - if perhaps we are talking about mental health too much? Could that be possible? These kids are being given very mixed information. Their school sends them the message of resilience and fortitude but they are constantly bombarded by talk of mental health, anxiety, low mood, depression and stress in the media. No wonder they are confused. Their head teacher promotes the idea of committing to schoolwork and building for a future and yet in reality these kids are allowed to sit out of class, listen to music to calm down and I’ve even heard of a student going to a pet store to have a bit of ‘me time’ during the school day.

Conversely, the children showing real strength despite the most heart-breaking situations at home sometimes need encouraging to open up. They live in survival mode and their resolve often prevents them from discussing their emotions at all. I’ve seen two students recently with devastating experiences of varying abuse and have had to encourage them to talk to someone they trust. Sometimes what they’re holding inside is too difficult to say out loud and they may not feel ready for a long time. There are days when sowing the seed of the importance of sharing the load is all I can do.

My other question is, does labelling every symptom or emotion actually help a child? I had an interesting discussion with a friend recently whose child has been diagnosed with separation anxiety. After sharing her experience at work, an older colleague suggested that maybe her daughter is just what was once called 'homely'. Kids who just like being at home. After my experience with county lines I’m not sure that being homely is a bad thing at all these days. Does it really help a child to be labelled as having ‘mental health problems’? I was told by a child recently that they have really bad ‘maths anxiety’. I instantly reflected on my own time at school when I used to dread my maths lessons and shrink at the back of the class in case I was asked a question. I found maths impossible to grasp and couldn’t wait for the lesson to be over. According to this child, I probably had what she called ‘maths anxiety’ too but because it was never labelled and because lessons were something you went to every day without question I just got on with it.

And that is what we’re seeing a real lack of now. Kids who just get on with it. So many colleagues and other parents I talk to are deeply concerned about this and our future as a society. I was talking to another friend of mine whose daughter is having counselling and when I shared this view she said she was so glad I’d said it. In a world where you have to be so cautious expressing opinions I think she’d been worried about feeling this way.

Of course I’m not saying we should go back to the British 'stiff upper lip' way of thinking. Whether you love or hate the Royals, anyone could see that the treatment of William and Harry at their mum’s funeral was destined for long lasting repercussions. Repercussions that are evident right now.

Completely suppressing emotions is unhealthy as we all know. I have relatives who have suffered great trauma and loss in their lives and, because of the era this happened in, were not encouraged to talk about it at all from what I gather. My dad lost his dad in a tragic accident when he was just 12 years old and the way it was handled was so different to how it would be today. I’m sure there are millions of adults, particularly men, suffering in silence over events from their past or present. I understand that mental health can be affected by many factors and sometimes there may not even be a clear indicator of why a person is feeling the way they are. Support is essential to help a person understand and deal with their issues but if you’ve read my blog Strong you’ll know I believe balance in life is paramount. I’m simply wondering if the subject of mental health has gone too far for our kids? With so many trying to get out of classes claiming their anxiety is the issue are we, by allowing so much time out, actually causing detriment to our children? At the risk of sounding cold, and I should point out here that I treat every single child with care and respect, I do wonder if mental health is becoming an excuse for some children. Definitely not all children but some. On the flip side, I saw a child today who never used to eat at school or do PE because of her anxiety. She told me that she’s started to do both of these things. When I asked her what had changed she said "I just told myself to get over it and get on with things’" To be honest this stunned me as it’s not an attitude I often see. And I was so happy for her because she exuded a lightness that wasn’t there before.

Last month I was speaking to an 87 year old man in my other role as a practice nurse about his health during lockdown. He’d been completely put out by it all as he was forced to stop working for a while. He’s since gone back to work and told me he’s sick of hearing about mental health in the media. He said "Grow up in the East End during the Blitz and then you’ll know about mental health". Obviously this is an extreme viewpoint and I wouldn’t wish war as a way of life for any child. But I see his point. His generation wouldn’t have seen the school nurse for a paper cut, for bending their finger backwards, for having ink in their hair or for having mud on their trousers. All reasons children have been sent to me. If these kids aren’t encouraged to sort this type of problem (and I hesitate to use the word problem here) on their own, how are they ever going face the world of work?

It baffles me when parents repeatedly allow their children to be sent home from school for no real reason. I don’t have any power to keep a child in school once the parent has requested this but sometimes I wish I did. I had a mum admit to me just last week that her daughter is a "drama queen" but could I just "pander to her". Again, I had to carry out her wishes but was left wondering what this would achieve. Professionally I feel this makes me look like a total mug and the kids will then expect me to be a complete soft touch at every visit. When a child has overcome a tough day and reached the end of their classes successfully they feel a real sense of achievement. They also usually learn that it really wasn’t that bad. If their parents aren’t encouraging this kind of staying power then I have no idea how they’ll hold a job down in a few years time. Of course every child deserves to be treated with kindness and care and I need to reiterate that I am not intending to make sweeping judgements of all children here. There are those who are in absolute need of appropriate support. But when you’re sent over 60 a day to assess, they also need to be seen with discernment to sift out those who are truly suffering and those who are playing the system. As I said at the start, I don’t have the answers but I do have increasing concern for our children and their futures.