1. DR POONAM BHATIA MBBS, DCH,PGDAP
DEWAS (M.P.)
Do we see such students

2. “...mental health is invariably linked with general health and success in the classroom and inversely related to involvement in the juvenile justice system."
(U.S. Department of Health and Human Services. Mental Health: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health, 1999.)

3. SCHOOL MENTAL HEALTH PROGRAMME
From Understanding To Action
All young people today face significant stresses in their lives. Some changes are part of normal growing up, e.g. growth and hormonal changes, as well as changes in relationships that young people experience with parents and society. Other stresses are more individual, like pressures to advance in school and to earn a living, peer pressures, family moves, school changes, parental fighting and divorce, or pressure to engage in substance abuse.
Many children make it through their youth without showing significant behavioral or academic difficulties. This is due to a combination of successful coping skills and to the amount of support available, as well as the degree of environmental stress encountered. Unfortunatly, it is not always possible to determine which children will develop mental health problems before they occur. Therefore, programmes need to include all children and adolescents, with interventions ranging from skills for mental well-being to specific mental health interventions.

4. Significant Stresses
Normal Devlopment
Individual Stresses
No significant difficulties
Judgment is difficult
Need for Programmes

5. Around 20% of the world’s children and adolescents are estimated to have mental disorders or problems. According to the WHO’s 2001 World Health Report on “Mental Health: New Understanding, New Hope,” during their lifetime, people as a whole have a 25% chance of having a mental illness or behavioral problem. Mental illness has several effects on the person, their family and their community.
Nearly 1 in 5 children will suffer from mental ds regardless of where they live & how well they do .They may fail academically, be socially rejected or have poor self image. They may also have difficulties in relating to peers & adults or have poor respect for society.

6. On average, about 800,000 people commit suicide every year, 86% of them in low- and middle-income countries. Mental disorders are some of the most prominent and treatable causes of suicide (Source: World Health Organization).

7. ECONONIC BURDEN Significant burden. Estimated cost for US 2.5% of GNP.
Direct vs Indirect cost.
Though difficult to quantify, mental illnesses put a significant burden on the economy due to its effects on families and caregivers, social and health services, reductions in employment and lower mortality. Costs estimated for the US have been placed at 2.5% of GNP. The overall costs to GNP are likely similar in developing countries. It is reasonable that the indirect costs (costs from unemployment and lost productivity) are higher while the direct costs (costs of medical treatment and services) are lower.

8. BIG IMPACT. LOW COST.
The financial resources needed to provide preventive mental healthcare are relatively modest: US$ 2 per person per year in low-income countries and US$ 3-4 in lower middle-income countries” (Source: World Health Organization).
Providing mental care costs almost nothing.

9. What is Mental Health??
Mental health refers to the maintenance of successful mental activity

10. What is Mental Health?
This includes maintaining productive daily activities and maintaining fulfilling relationships with others
It also includes maintaining the abilities to adapt to change and to cope with stresses

11. Many of the mental disorders begin at the exact time that youth are in or entering Jr. High, High School or University
Academic failure & social rejection often have a lasting consequence because failure to learn in school limits person’s chances to succeed in life .As a result these children are likely to drift from main stream & become targets of unemployment, homelessness, and other symptoms of social dysfunction.

12. What impact do you think this has on students?

13. The Plethora of Problems
Social
Rash driving, negative groupism, divorce.
Psycho-social
Drug addiction, conduct problem, oppositional defiance, aggression.
Psychological problems
Anxiety, depression, suicide, Phobias and obsession

14. Mental health problems may lead to:
Behavioral difficulties
Difficulties in learning
Difficulties in performance
School failure
School drop outs

15. The extent, severity, and far-reaching consequences of mental health problems in children and adolescents make it imperative that our nation adopt a comprehensive, systematic, public health approach to improving the mental health status of children.
The National Advisory Mental Health Council’s Workgroup on Child and Adolescent Mental Health, 2003.
NASP GPR/HCI

16. Mental health care should be part of a child’s general health care.
We must put mental health on parity with physical health in America !
NASP GPR/HCI

17. “Competent School Community”
WHY CHOOSE SCHOOLS
“Competent School Community”
All members of the school community are concerned about the welfare of each other
They know how to obtain help for those who need it

18. WHY CHOOSE SCHOOLS
Offering services in the schools improves access to treatment. 
School staff can work together to help students build health-related knowledge and skills from kindergarten through high school graduation.
Provider of mental health services. Schools are already the primary providers of mental health services for all children.

19. Other Reasons to Choose Schools
As multidisciplinary entities, schools are the best places to integrate and to coordinate the efforts of teachers, families, mental health service providers and administrators.
Mental health services are most easily and consistently provided in the educational setting. Problems of transportation & accessibility, are minimized .

20. Stigma is the polite word for discrimination
It pervades our entire social structure
Integrating mental health education in schools may help destigmatize mental illness

21. Teachers are concerned for
Aggression.
Suicide among children
Slow learning ,Declining interest in studies.
Early indulgence and adult behavior.
Increasing agg & declining int of stu in studies & inc trend for suicide among stu & early onset of adult like behav

22. What is needed to create mental health integration in schools??
We need to train teachers to understand and recognize mental health problems in students

23. In addition, mental health needs of teachers may be similar to those faced by students
Poor job satisfaction
Self stress and fear
Indifferent attitude
Expectations
Extra occupational burden.

24. After all, a more effective teacher, means more effective teaching, and more effective learners
Knowledge & skills can be maintained & updated through workshops & continuing educational activities.

25. Actions for Schools Provide opportunities for family members to
express concerns and share solutions.
Involve parents in planning and in decision
making related to school mental health.
Establish frequent, clear communications with
families.
Schools need to provide
We have to involve families INVOLVE PARENTS IN PLANNING
PROVIDE TRAINING
ESTABLISH COMMUNICATION

26. Actions for Families
Encourage children's healthy behaviors by praising appropriate behaviors and acting as positive role models for children.
Encourage children to adopt good eating and physical activity habits.
Learn about and reinforce the skills and messages in their children's mental health and physical education curricula .
Role of parents in develop SMHP

27. Psychosocial and mental health issues present in all schools and indicates who is likely to be affected by these issues:
Issues of well-being and psychosocial competence affect the entire school community including students, teachers, school administrators, and members of the surrounding community. Specific mental health programmes improve coping skills, decrease stress, and increase support for a healthy school community.
Mental health knowledge, attitudes and behaviours affect all students and teachers. Educational interventions can make an important impact on the identification and handing of psychosocial and health problems.
It is important to identify children with psychosocial problems early and target them for intervention. These early problems in school frequently endure and predict later, more serious problems such as school failure and school dropout, too early pregnancy, drug and alcohol abuse, delinquency and low levels of adult earnings. Thus the cost of these problems to individuals, to families, and to a country is extremely hight (31). Good pre-school and school programmes can counteract some of these risks and decrease the costs.

28. Psycho Social Competence
Life Skills like
decision making and problem solving;
critical and creative thinking
communication and interpersonal relationship skills;
self awareness and empathy; and
skills for coping with emotions and stressors.
Psychosocial competence is a person’s ability to deal effectively with the demands and challenges of everyday life. The most significant interventions enhancing the child’s own coping resources and competencies. This is most often done by teaching of skills; such skills are referred to as life skills.

29. Intervention Model
Successful model of intervention can be found at four levels:
A few children will develop serious mental disorders based on specific biological vulnerabilities, just as some children will develop other medical disorders such as diabetes, cancer, and asthma. Treatment by a mental health professional is important, as is a receptive and supportive school environment.
Psychosocial competence is a person’s ability to deal effectively with the demands and challenges of everyday life. The most significant interventions for the promotion of psychosocial competence in schools are those which enhance the child’s own coping resources and competencies. This is most often done by teaching of skills; such skills are referred to as life skills. decision making and problem solving;
critical and creative thinking;
communication and interpersonal relationship skills;
self awareness and empathy; and
skills for coping with emotions and stressors.

30. Levels I through IV can be likened to primary
Levels I through IV can be likened to primary. Secondary, and tertiary prevention efforts.
Primary prevention and health promotion (Levels I and II) target the interventions which to promote healthy behaviours and prevent a disorder from developing.
Secondary prevention (Level III) targets a more selected population of high-risk people to protect against the onset of the disorder.
Tertiary prevention (Level IV) targets people who already have developed the disorder with the intent of treating the disorder, reducing the impairment from the disorder, and/or preventing relapse.
Levels I through IV can be likened to primary. Secondary, and tertiary prevention efforts.
Primary prevention and health promotion (Levels I and II) target the causes of healthy and unhealthy conditions with interventions which to promote healthy behaviours and prevent a disorder from developing.
Secondary prevention (Level III) targets a more selected population of high-risk people to protect against the onset of the disorder.
Tertiary prevention (Level IV) targets people who already have developed the disorder with the intent of treating the disorder, reducing the impairment from the disorder, and/or preventing relapse.

31. What is needed to create mental health integration in schools
What is needed to create mental health integration in schools?? Surprisingly little

32. What is needed to create mental health integration in schools??
We need policies and plan that recognize integration of mental health into educational institutions

33. What is needed to create mental health integration in schools??
We need to develop region-specific infrastructure and supports

34. Effective School Mental Health Program
Involves families and community members as active partners in planning, implementation, and ongoing evaluation.
Utilizes the skills of school and community mental health professionals .
Intervenes at multiple level
Focuses on teacher training and parent training.
Evaluates its effectiveness and utilizes this information in programme modification.

36. We need to work as a team.
Schools recognize that mental health and well being go hand-in-hand with learning.
Communities recognize that many young people today need additional assistance in managing the stress in their lives
. Family members realize that they can benefit from additional support from the schools and want to be involved as partners in their children’s development.
The greatest resources in the development of healthy children are the young people themselves along with their families, teachers and communities.
Now is the ideal time for families, communities, and young people to rally around their schools to develop and support a comprehensive school-based mental health programme

37. TAKE HOME MESSAGE
Children & teens in this country are in dire need of expanded mental health services.
Schools offer easy access & familiarity to children & families.
Mental health services should be an available component for every child’s school experience.

40. Support of teaching programmes once they are in place
Support of teaching programmes once they are in place. This investment is worthwhile considering that the potential gains of life skills teaching are so far reaching and can have an impact on several levels, including:
For the child; protecting the child’s health (e.g. by preventing cigarette smoking (13), abuse of alcohol (15,47) and other drugs (14), and promoting the child’s social interests (eg. By improving relationships with peer (63);
For the teacher; improved relationships with pupils (44), and fewer classroom behaviour problems (63); and
For the school; improved academic performance (65), and a possible effect on levels of truancy and school drop-out.

41. PARENTS Rising anxiety and insecurity. Non responsiveness, Apathy,
Personalised attitude,
Disharmony and discord
Anti social

42. OBJECTIVES WHO’s concern on Mental health. Economic Burden
To explain what is mental health
Impact of mental health on students
Role of Schools Family & Community.
Components of school mental health program.