Chil­dren, stress and ev­ery­day life

● Pro­tect­ing chil­dren from stress could af­fect their abil­ity to func­tion in their ev­ery­day life

The Malta Independent on Sunday - - NEWS -

Gi­u­lia Ma­gri

Can you tell us about the train­ing pro­gramme?

Kutcher: What we are do­ing is bring­ing to Malta an ed­u­ca­tional men­tal health in­ter­ven­tion that has been stud­ied and ap­plied in many coun­tries around the world. It is highly ef­fec­tive for not only stu­dents, but also teach­ers, as it fo­cuses on un­der­stand­ing men­tal health and men­tal health lit­er­acy.

Camil­leri: Men­tal health lit­er­acy would in­clude things like not us­ing ‘anx­i­ety’ or ‘de­pres­sion’ to de­scribe ev­ery­thing. For ex­am­ple, it is nor­mal to ex­pe­ri­ence stress be­fore an exam; other­wise, it would not be a chal­lenge. It is im­por­tant not to bub­ble wrap kids, as peo­ple tend to work best when un­der pres­sure. A mod­er­ate level of stress, for in­stance, mo­ti­vates stu­dents to pick up a book and study.

Does the pro­gramme’s ti­tle re­flect the sit­u­a­tion in Malta?

Sal­iba: The idea is that we should not over pro­tect our chil­dren, be­cause this will im­pair their growth and de­vel­op­ment. One of the top­ics we dis­cussed is how to dis­tin­guish men­tal dis­tress from men­tal dis­or­der. A cer­tain level of stress can be help­ful, chal­leng­ing you to over­come ob­sta­cles and reach your full po­ten­tial. Bub­ble wrap­ping chil­dren dis­rupts this sort of de­vel­op­ment.

How can one dis­tin­guish be­tween good stress and that which is toxic?

Sal­iba: Stress is harm­ful when it leads to func­tional im­pair­ment; in other words, when it be­gins to in­ter­fere with daily ac­tiv­i­ties. This could in­clude so­matic symp­toms, changes in ap­petite, al­tered sleep pat­terns, as well as in­ter­per­sonal is­sues.

Camil­leri: Pro­tect­ing chil­dren from stress im­pairs their abil­ity to cope with ev­ery­day life, which is full of dif­fer­ent stresses. If stress is pro­longed, then it may de­velop into a men­tal dis­or­der. Still, we should re­mem­ber not use la­bels. For ex­am­ple, we should not say ‘This child has ADHD; we need to sort him out.’ It would be more help­ful to say ‘This child strug­gles to sit still in class. Is there any­one who can help us with this?’

Is la­belling en­trenched in our ed­u­ca­tion sys­tem and, if so, what does the train­ing pro­gramme aim to do about it?

Kutcher: La­bels are for soup cans; di­ag­noses are for peo­ple. It is im­por­tant to di­ag­nose peo­ple with men­tal dis­or­ders, but it is also im­por­tant not to mis­di­ag­nose those who are not suf­fer­ing from any dis­or­der. This pro­gramme tries to teach teach­ers, par­ents and stu­dents to use the right words to de­scribe what they see and not to jump to con­clu­sions.

Has there been a rise in young peo­ple claim­ing to have a men­tal dis­or­der or suf­fer­ing from ex­treme stress? If so, why do you think this is?

Sal­iba: We know that most men­tal dis­or­ders usu­ally de­velop be­fore the age of 25. The aim of this course is to iden­tify them early. There are a num­ber of rea­sons why stress has in­creased over time, such ex­ams, ap­ply­ing for univer­sity, re­la­tion­ships, breakups and child­hood trauma. This can af­fect a child’s aca­demic per­for­mance and re­la­tion­ships as well.

Kutcher: The preva­lence of men­tal dis­or­ders has not changed over the past 40 years. What has changed in the last decade is the in­crease of self-re­port­ing/self-iden­ti­fy­ing. As peo­ple start learn­ing more about men­tal ill­ness, they start ques­tion­ing whether they also have one and seek help.

We also have a big prob­lem with young peo­ple in­ter­pret­ing nor­mal, acute stress as ‘ab­nor­mal’. If they feel un­happy, they as­sume they have de­pres­sion; if they feel ner­vous, it means they suf­fer from anx­i­ety. So they seek help for nor­mal feel­ings, and this causes huge prob­lems as it leads them to be­lieve they are un­well. It also in­creases the de­mand for health ser­vices, which are al­ready lim­ited, to the detri­ment of pa­tients in gen­uine need of treat­ment. The poor and dis­ad­van­taged are hit the hard­est by this.

Camil­leri: Self-re­ported stud­ies show that 25% of young peo­ple are depressed, but the re­al­ity is they do not meet the full cri­te­ria for de­pres­sion. They might be feel­ing sad and low, but this is not clin­i­cal de­pres­sion. So we need to be aware of the lan­guage we use. We also touch upon the no­tion of stigma in men­tal health ill­nesses.

How is teach­ing of men­tal health lit­er­acy help­ing to de­crease stigma?

Kutcher: One of the things that peo­ple are learn­ing about is how to use a cur­ricu­lum re­source in schools and how to teach that re­source. As part of that, young peo­ple and teach­ers are be­ing taught to un­der­stand stigma and are be­ing given the tools to de­crease such stigma. The re­sult, as ev­i­dent from re­search car­ried out in other coun­tries, is that the stigma sur­round­ing men­tal health de­creases and re­mains low. That is very pos­i­tive. Once these ado­les­cents grow up, they con­tinue to carry this sense of un­der­stand­ing and, over time, we will see de­creases in stigma. Teach­ers are ex­tremely im­por­tant peo­ple; they have an im­por­tant place in the so­cial hi­er­ar­chy. Once they them­selves be­come less stig­ma­tised, we will see an im­pact on a wider level.

Do you be­lieve that the ed­u­ca­tion sys­tem is at fault when it comes to this in­abil­ity to cope with stress?

Camil­leri: I think that rather than a fault, we are all try­ing to im­prove our knowl­edge of men­tal health. The more we know, the more we can help and be ef­fec­tive. This is some­thing cultural, and prob­a­bly even in­ter­na­tional, where we as­sume that a child is anx­ious or depressed, which is prob­a­bly not the case. I be­lieve it is down to the lan­guage we use. Ev­ery­thing is con­nected.

Sal­iba: We should ac­knowl­edge that this train­ing pro­gramme is also tied with the Min­istry for Ed­u­ca­tion. Tak­ing on this cur­ricu­lum is a very pos­i­tive step for­ward.

What do you hope this con­fer­ence will achieve?

Sal­iba: We hope that this men­tal health guide will be im­ple­mented as part of the school cur­ricu­lum. We hope that stu­dents can bet­ter ap­pre­ci­ate men­tal health and men­tal health dis­or­ders, re­duc­ing stigma.

Kutcher: The health and ed­u­ca­tion sec­tors should work to­gether more of­ten. I feel that it is won­der­ful that the min­is­ter for ed­u­ca­tion has di­rect knowl­edge of the is­sue and has ex­pressed a great in­ter­est in it. That kind of ded­i­ca­tion in­creases the chances of suc­cess.

Dr Stan Kutcher, Emma Sal­iba and Dr Nigel Camil­leri

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