The Malta Independent on Sunday
Curriculum guide seeks to attitudes, remove mental O increase help-seeking health stigma in schools
The Mental Health and High School Curriculum Guide, which will be implemented in Church schools from this coming September, seeks to increase knowledge amongst teachers on mental health, reduce stigma and increase help-seeking attitudes.
Speaking with The Malta Independent on Sunday, Higher Specialist Trainee in Psychiatry Emma Saliba presented a detailed explanation of this evidence-based Mental Health and High School Curriculum guide. This guide deals with an array of topics related to mental health and highlights how adolescents and teachers can benefit from learning about mental health literacy.
“By means of this guide and training – by promoting positive mental health as well as healthy life skills – we aim to minimise the number of students that go on to develop a mental disorder. This would also help in identifying the students with mental disorders early on so that they can be referred for treatment and seek help. The earlier they seek help, the better the outcome,” Saliba said.
The guide was developed in 2009 in Ontario, Canada, by Canadian psychiatrist and expert in adolescents’ mental health, Dr Professor Stanley Kutcher. Despite the guide being developed pre-Covid, the material within the guide is still relevant as both pre- and post-pandemic mental health illnesses are still presented, treated, and managed in the same way.
“We have seen an increase in mental disorders post-pandemic so this guide is definitely more relevant than ever,” Saliba said.
Curriculum guide is aimed for 13 to 15-year-old students
Since 2009, the guide was taken up by twelve other countries, including the United Kingdom, the United States, Australia, amongst others. Each time feedback was gathered from a number of professionals in different countries.
The guide is specifically aimed for students aged 13 to 15 years, therefore, primary schools are not included. Saliba explained that the main reason for this is that “we know that 70% of all mental health disorders start between 12 and 25 years of age.”
She explained that this does not necessarily mean that a mental illness cannot develop under the age of 11 but it is more likely to develop at 12 years of age and over. The remaining 30% could easily include people who developed a mental illness before 12 or after 25 years.
Saliba explained that the benefits of the guide are twofold. It is beneficial for the school staff who will be teaching the guide but it also beneficial for the students who will be receiving the material.
“With regard to the school staff, we acknowledge the fact that teachers teach a number of students who come to school with a mental disorder and it can be challenging to teach these students. Therefore, the idea of the guide is to increase knowledge amongst teachers, reduce stigma and increase help-seeking attitudes. These three factors are all components of mental health literacy,” Saliba said.
Mental health literacy is lacking in Malta
Saliba noted that it is important to distinguish mental health literacy from mental health awareness.
Mental health awareness is knowing about something, whilst mental health literacy is about having actual knowledge on the health so much so that the individual would be in a position to make informed decisions about their own mental health care. Although awareness is very visible in Malta as it is also heavily covered by the media, the literacy aspect is lacking. Having mental health literacy reduces stigma and corrects misconceptions about mental health.
The development of the curriculum is accompanied with a four-day training program for educators.
In 2019, Saliba, together with the Ministry for Education, under the supervision of Dr Nigel Camilleri, was instrumental in bringing Professor Kutcher to Malta. The delivery of the training to staff was organised within government schools.
Since then, upon agreement with the Secretariat of Catholic Education, this May and June 2021, Saliba delivered the training to 71 members of staff, including educational psychologists, counsellors, guidance teachers, PSCD teachers and social workers within Church schools.
The initial plan was to implement this guide and training in the 2020-2021 scholastic year but due to the pandemic this was put to a halt and will thus start to be implemented this coming September instead.
Mental health guide to be implemented in PSCD lessons
Saliba noted that the main idea is to introduce ‘Mental Health’ as a school subject.
“Although we are working on it, upon discussions with the government and with the Secretariat, both in 2019 and now, we felt that PSCD lessons would be the best lessons to implement the guide in, as it allows a certain flexibility,” she said.
Furthermore, Saliba highlighted the aims of the guide, saying that teachers would not be expected to diagnose mental disorders but it would serve as a support for teachers to be able to identify a student who would benefit from an assessment made by a doctor or a psychologist. The aim of the guide is to help support teachers and provide them with more knowledge on mental health. This would empower them with regard to skills, competencies and managing students with mental disorders. Simultaneously, students would also learn about their own mental health, what the red flags are, when they should be concerned and when they should speak up and seek help.
In addition, the advantage of the guide is its flexibility. Teachers can adapt to it according to what is needed for their students by deciding what they would like to introduce in the class and what they feel might not be as important, Saliba said.
The syllabus itself is divided into six modules. These include stigma about mental illness, understanding brain function, information about mental disorders, lived experiences of people with mental illness, seeking help and finding support and positive mental health.
Saliba explained the modules, saying that the first one is extremely important because stigma needs to be properly addressed if a discussion is to take place. The second module offers students the possibility to learn how the brain works in a simplistic manner. The third module provides information for both teachers and students about different mental health disorders, whilst the fourth module is an opportunity to show students via visual means the lived experiences of young adults and adolescents who have suffered from a mental illness themselves. Lastly, the fifth and sixth modules focus on informing students on when and where they are to seek help as well as focuses on adopting healthy lifestyle changes and skills in order to minimise the development of mental disorders, respectively.
Mental health stigma still very much present
Speaking about stigma related to mental health, Saliba confirmed that this is still very much present, as although there is a lot of awareness, there isn’t enough mental health literacy.
“Stigma is not only seen among students but is also very evident among parents and families. Many times, the behaviour that we see exhibited by the student is a reflection of the situation at home. Therefore, parent mental health literacy sessions are also very important and are something which are being discussed as well,” Saliba said.
Asked what one hopes to get out of this project, Saliba elaborated on two factors.
“Firstly, I would like to see stigma on mental health reduced as much as possible, so that students, families and whoever suffers from a mental illness is more comfortable to seek professional help, without worrying about being judged, stigmatised or marginalised. Secondly, as much as possible, I would like to see the mental disorders being identified earlier on in order for the students to have better outcomes and a better quality of life, and thirdly, I would like to see more positive healthy life skills to reduce the likelihood of an individual developing a mental disorder,” Saliba said.
She added that, “at the end of the day this is an investment in the long run. These students are going to be tomorrow’s adults
with their own families, relationships, employment etc. If they have a mental illness which is not treated or identified, that will impact on these different domains later in life.”
Meanwhile, Service Manager for Student Services at the Secretariat for Catholic Education Marjoe Abela, expressed her contentedness in the guide and training program, saying that she was very pleased with this positive initiative for members of staff within Church schools.
“The members of staff who participated in the program said it was very helpful, insightful and beneficial. Their feedback was very positive,” Abela said.
She explained that prior to this training program, the team of psychologists within the SfCE devised a training programme for educators – Managing Wellbeing in Times of Change. This programme which was facilitated by the respective schools’ psychosocial teams was meant to raise awareness on the importance of the educators and students’ wellbeing for effective teaching and learning. The schools were offered an Activity Toolkit for students in Primary Schools and another one for students in Secondary Schools. The idea behind the toolkit was to support teachers incorporating activities addressing the students’ wellbeing within the curriculum.
The guide and training program offered by Dr Emma Saliba was a good follow up, Abela said.
A total of 88 participants including PSCD teachers, Guidance Teachers, Counsellors, Social
Workers and Youth Workers are planning to implement such programme in schools as from next scholastic year.
Speaking about mental health stigma, Abela highlighted that although this has improved within schools, especially amongst educators, it is still very much present. Considering the increase in mental health issues, including anxiety as well as suicidal thoughts amongst students, mental health stigma needs to be addressed.