Contents
Context
- Why Young People's Mental Health Is So Important
Introduction
The Performance and Workshops
How Did the Young Folk Respond?
What Questions Did the Young Folk Ask?
Summary Of Feedback and Evaluation
Collation and Analysis Of Evaluation Forms: Findings,
Statistics and Quotes
What Did the Teachers Think?
Lessons Learnt
The Way Forward: Recommendations and Future Plans
Final Thoughts and Conclusions
Context
- Why Young People's Mental Health Is So Important
The charity YoungMinds*
state that the average secondary school of 1000 pupils will have 50
students with depression, 10 affected by eating disorders and 5-10 attempting
suicide in any one year.
Why young people's
mental health is so important:
20%
of the nation's children suffer some degree
of mental or emotional problem…
Mental health charity, Mind
Approximately
10% of children and young people
have mental health problems that are severe
enough to require professional help.
House
of Commons Select Committee
Between
2 - 8% of adolescents suffer from
major depression, it being most common in girls.
Royal
College of Psychiatrists
The
suicide rate of young men aged 15 - 24 has risen by 75% since 1982.
Department
of Health 'Health of the Nation', 1992
"Children's
mental health matters. When they have it they feel good about themselves,
enjoy relationships, learn confidently and overcome their difficulties.
When they don't - when they are overwhelmed by misery, anger or fear
- all kinds of problems can arise."
YoungMinds*
*Youngminds is
a national charity committed to improving the mental health of all
children and young people.
Introduction
The Highland Users
Group (HUG), in partnership with the theatre company 'Live Wire Productions',
staged interactive drama productions during Scottish Mental Health Week
in four schools across the Highlands.
The high schools
we visited were:
Millburn Academy,
Inverness
Mallaig High School, Lochaber
Wick High School, Caithness
Thurso High School, Caithness
The focus of this
year's Scottish Mental Health Week was young people aged 14 - 18 and
this provided us with a great opportunity to work with over three hundred
and fifty 4th - 6th year pupils.
The information
and analysis in this report is based on the evaluation forms and verbal
feedback from the schools and HUG members. The main findings of the
evaluation forms are detailed in section G, entitled 'Collation and
Analysis of Evaluation Forms: Findings, Statistics and Quotes.'
HUG believes
that, in order to challenge stigma and discrimination, it is vital to
start raising awareness and understanding of mental illness with children
and adolescents.
Our experiences
during Mental Health Week, and the findings of the evaluation forms,
will form the foundations for planning HUG's future work with schools
and young people all across the Highlands. We are not proposing to present
any definitive answers and would greatly welcome any support, comments
or recommendations.
The Performance and Workshops
Live Wire Productions
was established in 1994 as a mobile theatre company to promote health,
science and environmental issues through the medium of drama. Their
mental health play, entitled 'Brief Encounters', is aimed at high school
pupils and provides a forum for exploring depression in youngsters and
the stigma surrounding mental illness.
The pupils had a
valuable opportunity to relate to the three main characters; a young
woman, her father and a chat show host who portray their own, personal
experiences of stress, bereavement, depression, treatment and recovery.
The performance
lasted about half and hour and engaged the interests of the young folk
immediately, whilst introducing the main themes and issues in a sympathetic
and understandable way.
After the performance
the pupils broke up into smaller workshops and had an hour or so to
speak directly to staff from community mental health teams, the 'Live
Wire' actors and HUG members, who spoke very openly and honestly about
their own experiences of living with mental illness.
The organisation
and facilitation of the workshop changed during the week as we gained
in confidence and learnt to understand how to make the pupils more comfortable
and able to speak about such personal and 'taboo' issues.
We also had a large
quantity of information leaflets on all the major mental illnesses,
stress, suicide and self-harm, which the youngsters were encouraged
to take away. The material we had was from:
- Youngminds
- HEBS (Health
Education Board for Scotland)
- Depression Alliance
- Mind
- Mental Health
Matters/SANE
- The Samaritans
- The Royal College
of Psychiatrists
- HUG postcards
(which went down very well)
- HUG newsletters
and 'Moonstruck'
Overall, the format
we developed helped the youngsters to gain a much greater understanding
of mental health issues and dispelled common myths and misconceptions
surrounding mental illness.
How
Did You Young Folk Respond?
For most of the
youngsters this was the first time they had had a chance to explore
and hear about mental health issues. Although the workshops were quite
imposing due to sheer number, once we broke up into smaller sub-groups
the pupils felt more comfortable and were able to speak to HUG members
and the professionals.
In one of the schools,
one pupil actually came up, thanked us very much for coming and said
how much the session had touched them. She also said that many of the
pupils were talking to one another about the issues and the impact the
workshops had had on them.
What
Questions Did the Young Folk Ask?
Once the pupils
were working together in small groups, they asked HUG members many thoughtful
and relevant questions, such as:
- What
causes mental illness and how many different illnesses are there?
-
How do I know if I am becoming ill?
-
How do you cope with having depression?
-
How did people react to you when you became ill?
-
What can I do to help a friend if they become ill?
-
Why do people self-harm?
-
How did you feel being in a psychiatric unit?
-
How do parents deal with their children when they have mental health
problems?
-
How easy is it to get professional help?
-
How do you know if you are a 'normal' teenager or suffering from depression?
-
To what extent are a mentally ill person's friends and parents affected?
-
What is psychosis?
-
What drugs do they treat with?
This type of direct
interaction with people experiencing mental illness appeared to make
a great impression on the pupils and, perhaps more than anything, helped
them to understand mental illness and realise the huge impact it has
on people's lives.
Summary
of Feedback and Evaluation
The impact and value
of this work was extremely evident in the comments on the evaluation
forms and informal feedback received from pupils, teachers and HUG members.
The majority of pupils credited the sessions as greatly changing their
perceptions of mental illness and 'madness', and how they would view
mentally ill people in the future.
Below are some direct
quotes from the pupil's evaluation forms:
What
did the words 'mental illness' make you think of before today? How have
your ideas and thoughts changed?
'People going mental, crackpots.'
'People being carted around in straitjackets with metal cages around
their mouths.'
'Nutcase, weirdo.'
'Nutters, mad people.Loopy people, Craig Dunain - not really sure.'
' Men in white coats, padded rooms and straitjackets.Difficult question.'
'Probably people who were completely mad, if you know what I mean,
rather than an illness like depression.'
'I
understand more about the illnesses.It made me realise these people
are normal.'
' I realise it could happen to anyone, and you can make a full recovery.'
'A lot - now know a lot more about illnesses and how they affect different
people.'
' Lot more understanding now.Completely different.I think I am probably
more open-minded about mental illness and the breadth of illnesses
this term covers.'
These types of quite
dramatic changes in attitude were echoed in the majority of the returned
evaluation forms from the pupils.
Collation
and Analysis of Evaluation Forms: Findings, Statistics and Quotes
The findings in
this part of the report will provide the base-line evidence for HUG's
future educational work with schools and young people. The results are
quite startling and provide confirmation in the value and necessity
of providing a safe forum for discussing mental illness.
Just over two hundred
evaluation forms were returned from the schools, out of the three hundred
and fifty pupils who attended the sessions. It was clear that the pupils
had completed their forms with great honestly and thought. Only a very
small handful of forms were 'spoilt' and not included. The statistics
and outcomes are based on 201 evaluation forms.
The responses in
italics are direct quotes from the pupils, and have not been changed
or paraphrased in any way. In questions 1 and 2, percentages have been
calculated to the nearest half percent.
1. 'HOW WELL
DO YOU THINK THE PERFORMANCE ADDRESSED THE ISSUES COVERED?
Very well 19%
Well 53%
OK 24%
Not at all 4%
2. HOW INFORMATIVE
AND INTERESTING DID YOU FIND THE WORKSHOPS?
Very 24%
Quite 41%
OK 26%
Not at all 6½%
In the following
questions, the percentages relate to the main themes/common strands
that emerged strongly from the evaluation forms:
3. 'WHAT DID
THE WORDS 'MENTAL ILLNESS' MAKE YOU THINK OF BEFORE TODAY?'
Crazy, mad, nutcase
29%
"Nutters,
mad people."
"Old
fogies in loony bins."
"People
going mental, crack pots."
Straitjacket and padded cells 9½%
"Men
in white coats, people being carted around in straitjackets with metal
cages."
"Pulped
food, wheel chairs, institutions, padded cells, straitjackets."
Killer, violence, unpredictable 5½%
"Psychopaths,
down's syndrome, serial killers, pedophiles, schizophrenics."
"Crazy
people capable of doing inhuman things."
"Mental
breakdowns and killers."
"Psychopath."
Learning disability/mental handicap 3½%
"I
thought it was people with a mental handicap or learning disability."
"A
small minority who are mentally handicapped."
"Craig
Phadrig, people bashing themselves off padded cells, nutcases that
are old."
Some understanding and sensitivity 14%
"I
wasn't aware of definitions, but was about the stigma attached and
some of the stereotypical media coverage."
"Someone
with psychological condition which affects the way they feel, think
or act."
"That
people were the same as other people but just had something wrong
with them, not their fault."
"I
have had experience with people who are suffering from mental illness
and have suffered from stress myself."
4. 'HOW HAVE
YOUR IDEAS AND THOUGHTS CHANGED?'
Clear, positive
change in attitude towards mental illness 69%
"They
[my ideas] are very different - the performance has really opened
my eyes and I feel a lot better that I know that it's not what I thought."
"I
learnt more, especially about depression which I didn't know could
have such serious hold on someone's life. I hope I would be able to
react to people with a mental illness in a better way and not judge
them."
Greater awareness and understanding of mental health issues 66%
"They
are just normal people with an illness."
"The
talk made me understand the illnesses a lot better and not to be scared
or judge people with these illnesses - I understand mentally ill people
much more."
"They
don't seem mad anymore, they just seem normal."
"I
am a lot more understanding now as I have been more closely associated
with circumstances that could potentially arise in my own life."
"It
has made me question my views and helped me to understand how and
why mental illness occurs."
5. WHAT ARE THE MAIN THINGS YOU HAVE LEARNT OR DISCOVERED?
How common mental
illness is 18%
"Depression
is very common and anyone can be affected sometimes in their lives."
"How
many people are actually affected by mental illness."
"1
in 4 people suffer from this at some point in their life."
That mental illness happens to 'normal' people/anyone can become ill
15½%
"Mental
illness is like a normal illness and you are not strange for having
one."
"That
normal, everyday people can become mentally ill."
"Mental
illness can happen to normal people."
People can recover, become 'cured' 11½%
"That
people can get rid of their mental illness in a bit of time. Also
that people with a mental illness are just the same as everyone else."
"Illnesses
can be cured or stabalised, depression is more than just feeling down."
"You
can be cured, you don't have to have a history of mental illness to
suffer from it."
6. ARE YOU SURPRISED
BY ANYTHING YOU HAVE HEARD/LEARNT TODAY?
Yes 66%
How common mental illness is 14%
"Yes,
and what they have to go through because they suffer from depression
and because people say things about them."
"That
the people with real mental illness were brave enough to talk about
it."
"One
man was a schizophrenic and he had a wife and children. I would never
have thought this possible."
No/not really
34%
"No,
because I have seen it before on TV and in real life."
"No,
I was just interested in the information they gave us."
7. 'HOW WOULD
YOU LIKE TO EXPLORE MENTAL HEALTH ISSUES?'
Discussion 52%
(Many
young people specified they would want to speak to people who had experienced
mental illness)
"Discussion
was very beneficial."
"I
would like more discussion because I feel that people need to know
more so they can deal with it."
"Discussion
with people who have experienced mental illness."
Drama 34%
"Drama
and discussions with people who have suffered."
"Discussions,
drama and meeting people who are ill to see what is different about
the illnesses."
"I
thought discussing it in a group was helpful and the drama was a good
idea as well."
8. WHAT SORT
OF THINGS WOULD HELP YOU GET THROUGH STRESSFUL OR UPSETTING TIMES?
- Talking to someone
I trust (including friends and family) 70%
- Support from
friends and family 48%
- Professional
support (GP, counsellor, hospital) 4%
9. 'WHAT ISSUES
WOULD BE IMPORTANT TO YOU TO TALK OR LEARN ABOUT?'
Stress and suicide
were clearly issues of vital importance to the young people and a number
of the pupils explained that these were realities in their lives. The
wish for information and a chance to discuss youth suicide was particularly
evident at Mallaig High School, with just over 40% of the pupils specifying
this on their evaluation forms.
Below are the main
issues the pupils wished to talk about or learn more about:
- Stress 38%
- Suicide 27%
- Major illnesses
23%
- Depression
22%
- Anxiety 11%
- Schizophrenia
9½%
- Eating disorders
1%
"Stress
and also suicide would be important to talk about because I feel these
are issues young people are faced with."
"I
think the issues of suicide especially among young men would be important
as well as stress and pressure."
"I
think any issue of mental illness would be interesting ….possibly
if you know enough about it you might recognise symptoms in friends
and help them."
"Anxiety,
major illnesses e.g. schizophrenia - these I don't know much about."
This type of tangible,
current information is vital to any future work HUG does with young
people in the Highlands.
What
Did the Teachers Think?
The teachers at
the four high schools were very supportive and appreciated the benefit
of bringing mental health issues to the forefront. Below are some comments
from the teachers:
"Because
mental illness is such a taboo subject in day-to-day conversations,
I thought the way it was done was brilliant. I thought the pupils
gained a great deal from the frank and open answers of the HUG members.
The play gave them some information and by breaking down into smaller
groups they gained the confidence to ask the questions."
"I
thought it was done very well indeed. The school will follow up on
it after the holidays…keep up the good work."
"…we
need to be educated about the improvements in life for mental illness
to help our acceptance and understanding."
Lessons
Learnt
The findings in
this section are based on feedback from the people who took part in
the workshops i.e. HUG members and staff from the community mental health
teams.
The main lessons
learnt during the week were:
School pupils do
want to explore the issues of mental health and mental illness. One
HUG member said, 'I was surprised how easy the young people were to
talk to … I can see how helpful it may be now or even in the future
of these young people's lives'.
Young people hold
very misinformed and inaccurate images of mental illness (based, it
would appear, on mass media portrayals), but are extremely receptive
to this type of direct work. The performance and workshops promoted
a major shift in attitude. 'I was impressed by the kids' was a comment
heard time and time again from HUG members.
Progression was
made during the week as HUG members, workers and the Live Wire actors
became more comfortable with the format and the school pupils.
Hearing directly from people who have experienced mental illness made
a great impact on the pupils. As one HUG member said from her contact
with the pupils:
'I
was quite nervous, but when the kids asked more questions it made
me realise they wanted to know more …. they do not want to be
ignorant'.
- We as users,
working with schools, pupils and professionals, can make a difference.
HUG members were able to see directly the impact of their involvement
in this type of educational work.
- We would all
have been more comfortable and 'safe' in smaller groups, as this would
be the most effective method of communicating; the large groups inhibit
discussion (which could be very personal).
- It might be relatively
easy to go back to the schools, once contact has been made and rapport
has been established with the pupils and teachers and we all know
what to expect.
- The young folk
found the medium of drama and contact with people who have experienced
mental illness very powerful and believe this an extremely effective
way of exploring the issues.
- Suicide is a
major concern for young people across the Highlands and stress is
a reality of their lives.
The
Way Forward: Recommendations and Future Plans
These productions will hopefully provide a starting point for HUG to
work with teachers, school pupils and young people throughout the Highlands.
HUG believes this work to be of vital importance in order to ensure
the mental wellbeing of young people and to raise awareness of the causes
and impact of mental illnesses, and so reduce the shame and stigma very
often associated with mental ill health.
We also hope to
develop future partnerships between HUG, statutory agencies and schools
across Highland. Current ideas to take this work forward are:
- Consulting directly
with young people across the Highlands to find out how they want to
explore mental health issues. Four pupils from Millburn Academy have
expressed an interest in being an advisory or consultation group for
HUG's future educational work with young people.
- Further strengthening
our contacts with Health Promotions to develop a Highland-wide approach
to the promotion of mental wellbeing.
- Training for
teachers on mental health issues during in-service training days.
The first scheduled date is for February 2001.
- Sustaining and
expanding the links we have made with high schools, by raising mental
health issues with pupils in their Personal Social Development classes.
- With the support
of the Royal College of Psychiatrist, piloting a board game, which
is a 'tool' for exploring mental health with teenagers.
- Develop closer
links to the Social Inclusion Partnership teams to reduce the incidence
of social exclusion as a result of mental illness.
Final Thoughts and Conclusions
Our experience,
in the space of a very hectic and emotionally draining Scottish Mental
Health Week, is that the pupils and their teachers welcomed the opportunity
to learn about and discuss issues of such relevance to young people.
There was almost a feeling of 'relief' that such a traditionally 'taboo'
area was being explored in such an open, non-judgmental way.
The young people
themselves found the medium of drama and discussion with users a very
good way of exploring mental health issues. In two of the schools HUG
members did follow-up work in the pupils' Personal Social Development
classes. These sessions were very successful as the issues were now
familiar to the youngsters and they had had 'breathing space' to talk
to one another or read the information leaflets.
A special thanks
must go to the HUG members, staff at the drop-in centres in Caithness
and members of the community mental health teams who provided invaluable
support and input during the week.
HUG would also like
to thank the Highland Primary Care NHS Trust's Endowments Fund, the
Health Education Board for Scotland, Highland Council Social Inclusion
Partnership, Highland Health Board Health Promotion Department and Moray
Firth Radio for their invaluable financial support for this project.
This report will be sent to key people in the Primary Care Trust, Highland
Health Board and Social Work Services, as well as to mental health organisations
and high school teachers across the Highlands.
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