Mental health: Cambodian and Irish students learn it’s okay not to be okay

Teaching about wellbeing and how to deal with undesirable feelings such as anxiety has been given short shrift for too long. There are many reasons for this, including a heavy curriculum and a lack of adequate teacher training. There’s also still a perception that talking about mental health problems can compound them, but this is a myth.

We cannot simply cure all ills, but we can break the omerta that exists in too many countries and in too many classrooms. More importantly we can also ameliorate some pain.

I know this first-hand from working on an educational partnership that teaches about mental wellbeing. I’ve taught children in Ireland, and teenagers and young adults in Cambodia, and both groups benefited from the workshops. Both groups (11-12-year-olds in Ireland and 17-22 year olds in Cambodia) had 12 lessons in four key areas over three weeks, and although adaptations are needed, many of the same strategies worked equally well across the two countries and age groups.

The Irish primary school where I teach has a reciprocal educational partnership with a Cambodian NGO, with a focus on increasing global citizenship and wellbeing. Our module for nurturing positive mental health and dealing with anxiety aimed to enhance awareness of such issues among young people and to teach them techniques for dealing with undesirable feelings such as anxiety.

Why teach about mental health in either country? As teachers we believe we should foster an environment that nurtures the wellbeing of everyone we teach. Teaching about mental health early is important: 50 per cent of mental illness in later life starts before age 15, and 75 per cent by age 18. Increased wellbeing leads to better academic performance. Most teachers know that boosting a student’s self-esteem can go far beyond confidence-building.

The reasons people develop mental health problems are multifaceted. It’s a dangerous myth that those with more material possessions have less to be depressed or anxious about. The corollary should be dismissed too: should young people in Cambodia be depressed because their economic prospects might not be as positive? The ability to challenge and lessen undesirable emotions is a key life skill for everyone, regardless of age, culture, nationality or socio-economic background.

Teaching the value of taking care of one’s mental health and appreciating the goodness in life is as relevant to a child in Donabate as it is to a young adult from Chanleas Dai, Siem Reap.

Take anxiety as an example. Through my work with both sets of students, I know common triggers for anxiety are friendship concerns and allowing opinions of others to influence one’s sense of wellbeing.

Anxiety for an 11-year-old in Ireland, for example, can come from concern about body image, the upcoming transition from primary to secondary school, or sexual orientation. Future employment, family health and emigration are more likely triggers for our students in Cambodia.

The age groups are different; the cultural backgrounds are completely different; the feelings are sometimes triggered from different sources. The feelings, however, are the same; the same physical sensations occur, and the same strategies for lessening the anxiety can be used.

Getting students to value their own mental health as something to look after and work on appears to have had a positive effect in both locations. It's clear that something as simple as 15 minutes' rigorous exercise a day can have a positive impact on wellbeing. Watching Cambodian students' moods lift after my Irish colleagues taught them traditional Irish dancing was a joy (watch it here). Equally I know the impact endorphins can have in Irish classrooms.

In Cambodia I have replicated and adapted these lessons and techniques (see right) with the students. The same strategies were used, with a very positive response: the students are extremely receptive to the topic and the approach. Interestingly, the students here in Cambodia were keen to learn about what issues may cause students in Ireland difficulties.

While this topic is not conducive to easy formal assessment, it is clear that both groups enjoyed the lessons, appeared more open to talking about their inner thoughts and used some of the interventions to deal with anxiety and stress. Hopefully it will continue to be of use to them.

Teaching on the subject of mental health and wellbeing cannot ensure students will be equipped to cope with the challenges they face as they mature. But this project, on two different continents, to two very different groups, gives two sets of students deeper understanding of mental health, and the knowledge that no matter where you are in the world, sometimes it’s okay not to be okay.

[ pepycambodia.org ]

MENTAL HEALTH: STRATEGIES AND TIPS

In Dublin we developed practical modules, easy to deliver in the classroom or to replicate in different settings. We focused on four key areas, using the following strategies:

1. Learning environment Making our learning environment more appealing can have a meaningful effect on our mood. We began with a classroom audit and empowered the students to make changes to the physical environment. Mirrors were put in bathrooms, posters hung, and children personalised their chairs with laminated posters.
2. Lifestyle The students learned strategies for getting a good night's sleep; how exercise is beneficial for the mind as well as the body; and the importance of a balanced diet. Many students used devices with a backlight at night so a change of bedtime routine was encouraged. We tried daily exercise and students scaled their mood before and after the workout. Students were encouraged to keep a food diary and to develop a healthy relationship with food.
3. Doing something you enjoy everyday The students shared something they enjoy doing in their free time. Often we fail to do enjoyable activities when we're anxious, which only compounds the problem. This module reminded students a good way to alleviate anxiety and stress is to bring attention to the positive and enjoyable things in their lives. Participating in sport, drawing and cooking were popular choices of activity.
4. How best to deal with undesirable feelings? Feelings of anxiety, jealousy, anger, frustration, sadness and stress were covered in this module. We identified these feelings and differentiated between them, then sought to normalise the feelings. Often the feelings are worsened by shame or embarrassment. The student often reports the physical symptom of the feeling (for example, upset stomach) and not the feeling itself, as this would mean something was "wrong with them". We encouraged the mantra "it's okay not to be okay". Students learned to recognise the feeling for what it is. Through class discussion they gained an appreciation of the commonality of undesirable feelings. Finally the students were encouraged to be proactive in dealing with the feeling (although these feelings can sometimes be useful; for example, anxiety in a fight-or-flight situation). This proactive step could be talking about the problem, keeping a written record of the thought or letting the thought pass. An anonymous Worry Box in the classroom can be an outlet to record feelings and communicate with the teacher about concerns.