Counselling, yoga and music therapy: Is this primary school of the future?

Campaigners say approach of offering therapy at school should be adopted across the State

Welcome to the "wellness hub" at Corpus Christi primary school. Here you'll find one-to-one counseling for pupils and parents, play or music therapy for children and regular mindfulness classes.

Tiernan O’Neill, principal of the Moyross-based school, says the programme - known as “the sky is the limit” - came about when he saw how children were being impacted by difficulties in the community.

“It’s very difficult for children to park psychological and emotional difficulties at the school gate and come in and engage with education,” he explains.

So, the Deis school developed a school care team with the school principal, home school community liaison worker, family support workers and other organizations.

This team is overseen by Dr Declan Aherne, clinical psychologist and retired head of student counseling at the University of Limerick.

“Schools are safe, familiar places with strong relationships between staff and parents so children and parents are more likely to avail of services in the school,” says O’Neill, who is currently on secondment to the Limerick Regeneration Project.

“And once you support children socially and emotionally, it has a hugely positive knock-on effect on their academic work. We’ve seen improved behaviour, attendance and significant gains in numeracy and literacy.”

Model

Given the incidence of mental health issues among young people, could this on-site counseling service be a model for other primary schools across the State?

A growing number of teachers, parents and mental health professionals believe it is. Many feel that children’s lives have become much more complex and that a whole school approach – with mental health resilience skills for pupils and staff alongside individual therapies for children and parents – would be the best way to equip our young people for later life.

'Mental health issues previously expected in older age groups are now more present in younger children'

Aine Lynch, CEO of the National Parents' Council - Primary (NPCP) says that children nowadays have to deal with multiple stresses in their lives.

“Mental health issues previously expected in older age groups are now more present in younger children. Children are soaking up so much more information now from various media without the life experience to process it. Family separation is more prevalent. There are complexities in the family make-up and adults experiencing mental health issues.”

One Irish study found that up to one in three children under 13 experience mental health difficulties. Mental health awareness programmes currently run by the National Parents’ Council are the most requested and attended courses the organisation runs.

While Lynch acknowledges that some children will need specialist mental health support, she believes that low level mental health issues - separation anxiety, school phobias and some behavioural problems - could be better dealt with through school-based counseling.

“Mental health support teams in school could give children ways to manage their mental health so that as they get older, they have better coping mechanisms for the stresses in life. And if fewer children are referred to specialist mental health services, the waiting lists for these services will go down and they will be getting more appropriate referrals,” says Lynch.

Waiting lists

Currently, children can wait up to two years following a referral to the community based Child and Adolescent Mental Health Services (CAMHS). And referrals have increased by over 40 per cent in the last ten years or so.

A survey of over 1,200 school principals by Dublin City University in 2018 threw light on the extent and range of emotional problems faced by young people. Family issues and relationship breakdown were reported to be the most common underlying causes of distress in children. Bullying, cyber-bullying, self-harm, depression, suicidal ideation, eating disorders and sexual identity issues were also cited as significant issues.

The National Parents Council - Primary joined with St Patrick's Mental Health Services earlier this month to host a webinar calling for the introduction of mental health supports in Irish primary schools.

This webinar, supported by the Irish National Teachers' Organisation and the Irish Primary Principals' Network and Ombudsman for Children Niall Muldoon, heard how school-based mental health support services in the UK and in a school in Limerick city operate.

'If we deal with the mild to moderate mental health issues in children, we are able to prevent a crisis further down the line'

In England, mental health support teams work across a number of schools in each area with school nurses, mental health visitors and other mental health organizations. Lesley Wakefield, who spoke at the webinar, is a programme manager of the children and young people mental health team in the south-west of England.

“One in five children will have a mental health problem by the time they reach adulthood. If we deal with the mild to moderate mental health issues in children, we are able to prevent a crisis further down the line,” says Wakefield.

The key to these early intervention services (which have on average a four week waiting list) is to give children the support when they need it - when things start to go wrong.

Dramatic

Research into the UK early intervention model found that between six and eight cognitive behaviour therapy sessions can dramatically reduce separation anxiety, panic, social phobias, obsessive-compulsive behaviour and depression in children.

A study in Wales found that 90 per cent of the children seen in these early intervention services didn't need onward referral to specialist mental health services.

The Covid-19 pandemic and particularly school closures have also taken its toll on children’s mental health.

One study found that almost 20 per cent of parents sought some form of mental health support for their child over the past two years. During school closures, Childline had an increased demand for its services and when schools re-opened, Parentline said that many parents were worried about their children’s refusal to return to school.

John Church, chief executive of the Irish Society for the Prevention of Cruelty to Children told an Oireactas committee on the impact of Covid on primary and secondary education that tensions which had been simmering under the surface in homes arose during the pandemic.

“In some cases, children experienced adverse childhood experiences for the first time,” he said.

In his contribution to the that same committee, Niall Muldoon, Ombudsman for Children, said on-site counseling “has been shown internationally to offer enormous advantages to schools and their communities by affording children the opportunity to normalise speaking to someone about their emotions and feeling down.”

In its report, that Oireachtas education committee recommended that that "emotional counseling and therapeutic supports should be an integral part of the primary school system and not an add on or intermittent service."

It also recommended that the National Educational Psychological Services (Neps) should be reconstituted and expanded urgently as the National Educational Psychological and Counselling Service and “mandated to provide specialist emotional counseling and therapeutic supports, on site, in all primary and secondary schools” and that this service should be “adequately resourced and funded to ensure it can deliver on its mandate”.

'If you can help children with their mental health and make them socially comfortable and emotionally strong, the education system changes forever'

Speaking at the NPCP webinar in February, Muldoon added: “If you can help children with their mental health and make them socially comfortable and emotionally strong, the education system changes forever.”

Teachers and psychologists who have studied models for school-based counseling suggest that so many children need mental health supports that that in-school therapy services would complement the work currently being done by Neps and CAMHS.

O’Neill says school-based therapy has transformed the experiences of children at Corpus Christi primary school.

“The medicalisation of issues has been greatly reduced and fewer of the children in our school are medicated as a result of this early intervention,” he says.

“The key is to offer therapy to children (and parents) at an early age rather than waiting until the children are 10 or 12 when the problems have spiraled out of control,” says O’Neill.

Currently 40 children and 40 adults are receiving one-to-one therapy at the 370-pupil Limerick school.

The NPCP and St Patrick's Mental Health Services now plan to bring their case for a countrywide primary school based mental health supports to the Department of Education and the Department of Health.

“There is already a pilot project in place where clusters of schools are offered therapeutic supports for children with special educational needs,” says Lynch.

CEO of St Patrick's Mental Health Service, Paul Gilligan says : "Early intervention services will reduce the number of children referred to community CAMHS but ultimately, children' mental health is a children's rights issue which is justification for the service in itself."

SIDEBAR

Children's mental health: in numbers 2 years

- The potential wait-time for a response following a referral to the community-based Child and Adolescent Mental Health Services

40%

- The estimated increase in referrals to CAMHS services over the past decade or so.

33%

- The estimated proportion of children under 13 who have experienved a mental health difficulty, according to one Irish study.

Five ways to boost your child’s wellbeing

Place2Be, a children’s mental health charity that provides counselling and mental health supports in UK schools, has the following advice for parents:

1. Celebrate your child’s strengths and differences

Help your child to recognise, and love, their own qualities and interests¨. Celebrate what makes them an individual and encourage them to see those positives and be a friend to themselves.

2. Have open conversations about feelings

Be a good role model and share your feelings openly with your child. This will show them that it’s okay to talk about how they feel - whether they feel happy and excited, or worried and sad.

3. Help your child to come up with their own ways to cope

Parents often want to fix things for children – but it’s important we give them a chance to deal with difficult situations on their own. Make it clear that you will step in if your help is needed, but empower your child to come up with their own ideas to cope with problems by asking them questions like, ‘how could you respond?’, ‘what do you think might help?’.

4. Let them experience their feelings fully

Every feeling is valid - so try to avoid minimising their feelings or rescuing by trying to instantly make them ‘happy’ or saying things like ‘don’t be sad’. Instead, talk to them about their sad feelings and tell them it’s okay to be sad sometimes.

5. Make yourself available to listen

Sometimes your child may not want to talk, and it’s important we don’t force them to have a conversation they don’t want. Make yourself available but don’t pressure them to talk. You may find that your child opens up in situations where they feel less pressure – for example, when you’re in the car on the way home from school.