The Impact of Covid-19 on Children's Mental Health with Professor Siobhan O’Neill, NI’s Mental Health Champion

Posted in : Supplementary Articles NI on 3 March 2022
Legal Island
Legal Island
Issues covered: Mental Health and Wellbeing; Covid-19

Professor Siobhan O’Neill , NI Mental Health Champion outlines the short and long-term impact that Covid-19 has had on children’s mental health and what teachers can do now to ameliorate the situation as much as possible. This webinar was held on the 3rd March 2022 in association with the ASCL (the Association of School and College Leaders) and following a presentation by Prof O’Neill a Q&A session was held.  

Also on the panel are:

- Graham Montgomery, Association of School and College Leaders Northern Ireland President 2022

- Nicola Connery, Principal of Strathearn School

- Elizabeth Huddleson, Principal of Bangor Grammar School

The Recording:

 

Children’s Code: What it Means for Online Services

You may also be interested in our upcoming webinar on the Children’s Code: What it Means for Online Services which will be held on Wednesday 23 March 2022 (11.00am - 11.45am) with the Information Commissioner's Office. 

The Children’s Code sets out 15 standards organisations must meet to ensure that children’s data is protected online. The code will apply to all the major online services likely to be accessed by children in the UK and includes measures such as providing default settings which ensure that children have the best possible access to online services whilst minimising data collection and use. Michael Murray, Head of Regulatory Strategy at the Information Commissioner's Office, sets out what this new Code will mean for children and service providers.

This webinar is suitable for anyone who provides or markets their services in Northern Ireland, particularly those whose audience includes children and young people. This event will also suit teachers and principals in schools and colleges of further and higher education. Parents may also find Michael’s presentation of interest.

Please send any questions in advance to Katie@legal-island.com

Register here: https://attendee.gotowebinar.com/register/5374665044177192463?source=website

Transcript

 

Graham: Ladies and gentlemen, good afternoon, and welcome to this important seminar on the Impact of COVID-19 on Children's Mental Health. The Association of School and College Leaders is delighted to host today's seminar organised and facilitated by our long-standing partners at Legal-Island.

And it's great that we are joined by leaders in pastoral care from across the province, clearly indicating the importance of this area to our world and our thirst to know more about how we can maximise our effectiveness on behalf of children and young people.

I'm Graham Montgomery, the President of the Association of School and College Leaders, Northern Ireland branch. And I'm joined this afternoon by two colleagues from the Association's executive committee, Elizabeth Huddleson, the Principal of Bangor Grammar School, and Nicola Connery Principal of Strathearn School, and they will facilitate the question-and-answer session later this afternoon.

Please drop your questions into the question box and Nicola and Elizabeth will pick them up and facilitate that toward the end after the professor's presentation.

At the end of our time together, you'll also hear from Robert Wilson, ASCL's regional officer, who'll have some important information for us all.

It's a privilege today to be able to hear from Professor Siobhan O'Neill, Northern Ireland's Mental Health Champion. Siobhan is a professor with over 20 years of experience in her field and is currently Professor of Mental Health at Ulster University with research programmes including trauma, mental illness, and suicidal behaviour in Northern Ireland.

In her role as Mental Health Champion, she advises and assists in the promotion of mental health and wellbeing through policies and services, and is described as a voice for those otherwise voiceless. Professor O'Neill is Northern Ireland's first Mental Health Champion and was appointed to that role in September 2021.

It's our great privilege to have her this afternoon, and I'm pleased now to ask Professor O'Neill to make her presentation.

Siobhan: Hello, everybody. I'm trying to share my webcam on the screen. Hopefully, you can see me there. And that's not the screen you want to be seeing, so let's try and get the right screen. There we go. Okay. And hopefully, you've got my slides now. So if somebody could just let me know if that looks right. Wait a wee second. This is what we're looking for. Okay, thank you.

It's such a pleasure to be here this afternoon. Thank you for inviting me. And I need to apologise because on the original date that I was supposed to give this presentation, of course, the two red lines came to our house and I had COVID and my daughter had COVID and just wasn't able to do it. So it's something that has caused a lot of stress in my house certainly, and I know that many of you have had the same experience. So apologies for that, but it is great to be back. We've recovered fully now and all is well thankfully,

So I'm going to talk to you today about the impact of the pandemic on the mental health of children and young people, and indeed, all our mental health because we're all connected. And I'm going to talk a little about what we should do about it and a bit about my role as mental health champion.

So hopefully, there'll be plenty of questions at the end. So get your questions into the question box for the last 15 minutes of this.

As I said, I spoke about COVID there coming to our house and it was very, very stressful. And stress is really such an important component in this whole mental health arena. Stress is absolutely crucial to our understanding of mental health and mental illness and wellbeing. So I wanted just to start with a little discussion about stress.

Normal Responses to Stress

I present this slide to show you the very normal things that happen whenever we have stress in our lives. Stress is really a way of activating the body and brain so that we can react to a situation of stress of danger where we're under threat, really. So it's about our brain perceiving that there's a threat and our body responding to that threat. That's what stress is.

Unfortunately, lots of the stressors that we have now in our lives are stressors that are chronic. They last over long period of time, and the things that our bodies do in response to that stressful feeling or that perception of stress and fear don't serve us well.

And if we look at the things that happen normally when we have stress, when we have a fight or flight response, the body is preparing to fight or run away. What happens to our brain? Well, our thoughts become mixed up. We get easily distracted, because essentially we're preparing to fight, really. Our concentration is not so good. Our memory is not so good.

Emotionally, we get irritable. We're easily activated, and of course, that makes sense if there's an enemy coming from behind us. We get angry. That's a very normal response to threat as well. It prepares our body to fight.

Physically, we're not too interested in sleep or eating. Our body activates again. The muscles become tense so that we can fight. We get more energy. And again, this is all very, very normal naturally.

And socially, we get into arguments. We start to blame other people. We're looking around for who to blame for the situation to find out where the enemy is.

So I'm conscious I'm using all these wartime analogies, and seeing that on the TV every night, but that is . . . We see in the TV now with the Ukraine invasion, the effects of that stress, that fear, and people are preparing to fight. But that's what our bodies are doing whenever stress attacks us, essentially. And stress is a perception.

But if you look at all of these symptoms of stress, very normal responses to stress, they're the same as the two most common mental health problems, which are anxiety and depression.

Depression is feeling that the world is a very terrible place and feeling very low. And anxiety is that kind of activation that many of us experience when we're under stress and pressure.

This is another way of looking at it. I use the circuits of survival slide again to explain the impact of stress on the body and brain and what it does to us.

Most of the time, we would like to be in that safe and social place in the middle, and that's where we can be productive and creative. But we need to feel really psychologically safe in order to be in that safe and social place. So we're calm, we're engaged, we're connected, we can see other people's perspectives. It's not about the fight. It's about understanding. It's about connecting.

And it's in safe and social where we want our children to be if they're going to learn. Now, we want a wee bit of stress to get them into the class, to get them activated, to get their books out, and to get them out the door in the morning. I don't know about everybody else's house . . . We need to get things moving and sometimes that can be a bit stressful.

Fight or Flight Reaction

So a little bit of stress is normal, but by and large, we want to be in safe and social, and that's where we do our best work really. And that's where we achieve our goals, whenever we're in there.

Whenever we have danger or threat, we go up into fight or flight, we become mobilised, more vigilant. It's about running, and anger, and fighting back. So there's a bit of that in all our lives, and that's normal and natural, but we don't want too much of it. And we certainly don't want to get stuck up in there all the time in that fight or flight place.

And unfortunately, if we have a lot of stress, especially in childhood as the brain is developing and trying to recalibrate the settings there so that the body has the best advantage in the world that the person lives in, there's a lot of stress and pressure in a child's environment in those early years. They become more hyper-vigilant. They can get stuck in that fight or flight place more easily. So these thresholds can become recalibrated, especially based on the early environment in those first few years of life.

The third space there that I have is shutdown, and this is the trauma. This is where we go whenever we are in trauma. It's a frozen, non-disconnected, disassociated sense of hopelessness.

Again, this is where we have a really severe threat or stressor that's overwhelming. Somebody has just died, our world has been turned upside down, that's an overwhelming stress, and our brain nearly disconnects to help us survive.

Dissociation can be part of that as well, and we see that with abuse victims who essentially are able to numb themselves to the point where they're not actually experiencing that situation the same way.

So that can be analogous to depression as well, where the person becomes stuck in a state of disconnection, of dissociation, of suicidal thinking, terror, hopelessness. So these are all kind of normal responses to threats, to stress, to pressure, to trauma, but it's really based on the circuits of survival in our bodies and brains.

And I suppose my point here is that repeated activation of these responses of the trauma response or the fight-or-flight stress response can recalibrate the thresholds and means that the person, particularly if it's a child, slides down into shutdown more easily or up into fight or flight more easily. That's the effect of childhood adversities and childhood trauma, and that's what a lot of us are actually dealing with and have been dealing with.

So, when we talk about the impact of a pandemic and mental health, we need to conceptualise it as stressor, as a very stressful experience. All of us have gone through the pandemic, but some people have endured worse stress and pressure than others. And for some people, the pandemic has been really traumatic

The things that happened to young people, particularly in those first stages of the pandemic, their lives really were torn from under them. Their schools were closed. They had to be at home. Some of them were at home in situations where they were being abused. So those children had a much worse experience. So it was stressful, and for some children, it was traumatising.

And just being away from their friends was very, very stressful as well because children need the social connections, the peer connections to be in that safe and social place, to be regulated.

Emotional Regulation

So emotional regulation is really the process of moving from fight or flight to back to safe and social, or moving from shutdown back to safe and social. So, back into that good space where we can be productive and creative, that's emotional regulation, and that's the key.

But unfortunately, a lot of our young people were plunged into situations that were very, very stressful and even traumatic as a result of the pandemic. And the concern now is that because this happened at a time when their brains were developing and calibrating to the world that they live in, this may have a long-term effect if we don't act now to rebalance that.

The good thing is there's lots of neuroplasticity in the early years and throughout childhood. So the interventions that we can use right now will be really, really helpful in rebalancing that and getting those kids back to the safe and social place and essentially rewiring what has happened.

So I put in this little quote here because I think it's really relevant. What I'm trying to say is that we need to be able to regulate our own emotional response. We need to be able to know as human beings when we're in safe and social, and when we're in fight or flight, and when we're in shutdown.

And incidentally, fight or flight and shutdown can happen at the same time where we can become really anxious really disconnected. And PTSD would include an element of both of those states.

So, whenever we're under stress and pressure, we're not really responsible for what our brain does, for our first thought, but as adults particularly, we have to make ourselves responsible what happens next.

Self-awareness is just so important to the whole mental health picture, and self-control and self-management, so that we can get ourselves back from fight or flight into that safe and social place. And as adults, we need to learn how to do that.

Our job as educators, I think, is to help our children do that as well, recognise whenever there's stress. We need to reduce the causes of stress, obviously. But there are things in our everyday environments that also cause us a lot of stress and there's a lot we can do there.

But the first thing that we need to do is recognise whenever we are in that stressed-out state, whenever our body and brain have reacted and there are a lot of thoughts and feelings that come at that stage, and then we need to take control. So self-awareness and self-control are so important to the whole piece around emotional regulation.

So let's look at some data on what happened to children and young people during the pandemic and what the evidence shows us.

The Impact of the Covid Pandemic on Children

So this is a very busy slide, apologies for that. But let's just go through it.

The first point there is that . . . and most of this is based from the Co-Space Study. It's one of the best studies that's been undertaken in Europe, and Ireland, and Northern Ireland. And in the UK now, very small sample here.

But what that study showed us is that this . . . just confirmed, really, that this was an incredibly stressful time for children and young people, particularly children at primary school age.

And of course, they had less access to mobile devices to contact their friends. They were more powerless. So being powerless and not having any autonomy is a very destabilising state to be in, and younger children particularly experienced that. And they demonstrated symptoms of at that stage that would indicate dysregulation. So the fight or flight, those symptoms.

So it's behavioural problems, it's problems controlling their emotions, more restless, difficulties in paying attention. Exactly those symptoms of an activated stress response, but it's seen in the behaviour of children.

So they wouldn't have met the criteria for anxiety, clinical levels of anxiety and depression, because in order to meet the criteria for those as mental illness, you need to have that for a significant period of time. It needs to interfere with all of your roles. It needs to be not letting you live your life. But the symptoms were there of acute stress.

And in boys, particularly, you see behavioural problems, angry outbursts. Very natural and normal responses, particularly in those young age groups, but it looks like bad behaviour and that's the problem. And, boy, does it stress us out as parents when we see it. It's really difficult to manage.

A third of primary school-aged boys and nearly a quarter of girls have hyperactivity or inattention, difficulty paying attention. Again, stress, pressure, that's what causes this. The lack of psychological safety, being away from your friends, not knowing when you're going to see your teacher and everybody again, really difficult.

In January last year, at this time last year, around a third of school-aged girls had emotional problems compared to 15.6% of boys. So this is where we really start to see the gender differences coming out. Boys externalise. They're more likely to externalise in response to stress and pressure. They act out. They get angry. Girls are more likely to internalise. They get anxious. They ruminate. They have cycles of negative thoughts that get them into a state, whereas boys lash out.

It's hormonal, it's social, it's all to do with modelling what they see their gender doing around them, and it's all to do with acceptable behaviour for either gender. But this is how it manifests.

So we see that situation where boys externalise and girls have these emotional problems where they can get really depressed and really anxious. Those are the highest levels.

Now, that was last year. Remember, last year, we were a year into the pandemic, but we were at another peak. We had a lot of school closures after Christmas. It was very grim. It was a really, really difficult time, and I guess there was a sense of hopelessness and concern about when this would actually ever end.

So there was a meta-analysis of 27 studies, actually, that showed us that school closures can cause considerable harms to health and wellbeing. Now, we'll have a debate at a later stage about whether they were necessary, but at the time, it was felt that this was the right thing to do. But closing schools was really detrimental to young people's mental health and wellbeing.

It's going to take a while for that to be addressed, and there may be changes that happen there that affect children for the rest of their lives. I'm sure you're seeing it in your classrooms, especially those wee early years, the building blocks that just weren't put in place at the right time. They didn't get the right curriculum in terms of all of . . . the early writing and stuff. My child is 4.5, so I'm so conscious of the stuff that they do in P1 as the groundwork for everything else that they're learning.

But also the social skills, the connection with their peers, what was the impact of all of that? And it was really stressful.

The other thing is that they were at home with stressed parents. Children don't exist in isolation and they rely on their caregivers to co-regulate. They rely on leaders and their families and their schools to help them regulate their emotional response.

So if they're at home with a parent who's very stressed, then they will be very, very stressed. They will pick up on all of those cues and they'll have the symptoms of anxiety that the parent has. So their environment there is crucial.

And of course, we know that the kids who lived in deprived areas, children with special educational needs, much worse outcomes.

I'm going to skip back here. There was also a decrease in emergency department presentations, a decrease in referrals to social services. Now, that indicates unmet need. So there were a lot of children suffering, but their needs weren't being met, and now we see an upturn in self-harm admissions and eating disorders now much, much worse, being caught at a worse stage. So these are all huge things that our health service is trying to deal with.

So children's mental health was getting worse, but they weren't getting the help that they needed.

There was an increase in screen time. There's very little evidence incidentally that screen time in and of itself is a negative thing. But if it's replacing sleep or physical activity, it is a problem. And if it's screen time where they're on social media and they're getting hit with things that are causing anxiety, then that's difficult. That is a very clear mental health risk.

But screen time in and of itself is fairly neutral. It's what they're doing and it's what they're not doing. So that's what I would say there.

But reduced physical activity is so important. Physical activity is essential to good mental health. It's the body's way of recalibrating, of regulating that emotional response, of telling the brain that the animal has been fought. We need to do it every day, and kids weren't getting that.

Impact of the Covid Pandemic on wellbeing on NI

Now, all of this comes in the context of the pre-pandemic levels of mental illness and children and young people here that were higher than other regions of the UK, 25% higher. One in eight of our children already had mental health problems. So this is adding on to an already difficult situation in terms of young people's mental health. So I am really worried and we are all really worried about this.

In terms of the general population, it's interesting that . . . This is from the General Health Survey of Northern Ireland. Life satisfaction and happiness decreased, but it only decreased a bit. It wasn't huge.

So adults are better able to cope with stress than children and young people. We've been through things before. We have more power as well, so we have more control over our own environment. We could choose whether or not to follow the guidelines to an extent. Young people had no choice. They had no power.

So reduction in life satisfaction and happiness, but only a little bit, and an increase in anxiety and loneliness, but only a little bit. However, the real differences start to show whenever you look at the gender differences, and the age group differences, and the area-level differences.

People who lived alone and young people had much poorer levels of wellbeing. All of the studies show that young people had more isolation and loneliness than those older age groups. And that is not in any way to take away from the suffering of an older person who lives alone, who needs help, and the isolation that exists in that population. But that 16- to 24-year-old age group, much more likely to feel lonely. Twenty-six per cent compared to the Northern Ireland average of nearly 20%. And the younger you go you go, right down under the primary school age groups, it was worse and worse and worse.

Women more likely than men to feel lonely, 16% versus 22% there. People in deprived areas are more likely to feel lonely than those in the less deprived areas.

The pandemic really exacerbated the impact of social inequalities that already have a huge mental health impact. And the impact of having to take on multiple roles particularly hit women in Northern Ireland. And we can see that with women who had children at home, who were home-schooling, and also doing jobs. And I know a lot of men were doing this as well, but the data is showing there that more women were affected by it than men.

A wee bit in purple at the end I found was really, really interesting. There are silver linings to this, of course. And the same study showed that the levels of self-efficacy, that belief in your own ability to change your own world, to have agency, and the levels of internal locus of control so that you feel that you have the power to influence what you do in life, what you become, those increased during the pandemic. And they're the highest now than they've ever been in Northern Ireland.

So, arguably, at a time when the government had introduced restrictions on our lives, we were really able to see, many of us, how much control we had, and the importance of taking agency and managing our own environment there. So I think this is a very positive message in the middle of all the negativity.

Separating the Stress from the Stressor

Moving along now to what do we do? How do we look after ourselves? How do we prevent mental illness? How do we keep ourselves well in the face of all of this? And what do we need to do now? This idea of separating the stress from the stressor is absolutely crucial.

So when we think about the effect of stress, there's something out there in the world that causes stress, whether it's a load of washing sitting downstairs that needs to be done, or an adverse work environment where there's bullying or something like that, or World Book Day sprung on us when we had to get an outfit. You know what I mean.

The stressors are out there in the world that we have to deal with. And then there's what it does to our body. Our heart starts to beat, we get all tense, and we start to panic, and we can't think straight. And that's the stress response, the fight-or-flight response.

So we've got these two things, and they're going against each other because the stress out there needs to be dealt with. We need to get the washing on. We need to get the child's World Book Day costume sorted out, which is a lovely experience actually in the end. But we needed to do all that and problem-solve, but the stress was kind of getting in the way of that. The body's reaction of, "Oh my goodness, what am I going to do here? Where will I go?" All of that stuff, which is normal, was getting in the way of problem-solving.

And we need to be good problem solvers. Remember, we're not responsible for our first thought, but everything else that comes behind it, we have to take control of that. So we need to separate out the stress. We need to deal with the stress in our bodies. That's the best way to get rid of it. And so we need to deal with the physical effects, and then we need to problem-solve.

So you can see that little brown bag there, which is the stress. There are external stressors, and then there are the internal stressors, and the fight or flight stuff and the symptoms of stress. That means we can't sleep. We take an extra glass of wine at night or whatever, or we don't eat well, or we get angry with people. And then that's just really poor, and that makes everything worse. So we're less likely to be able to deal with the cause of stress.

So we need to complete the stress response cycle in our bodies before we go any further, and we need to do this every single day because we're all living really stressful lives. We have privileges, but there's still so much stress that gets in the way of our ability to problem-solve.

So this is as good a slide as I've seen on how to complete the stress response cycle, how to deal with stress in our bodies. You see there we have mindful breathing. So actually interrupting that stress response and rebalancing it by using our breath. We breathe in a very shallow way when we're preparing to run away or fight the tiger or fight the enemy. Our breathing starts to prepare us for battle. And we need to just take control of that breath, which tells our brain then that we can cope. And then that stress response gets switched off.

Now if we can practise mindful breathing, we will be able to recognise straight away when it's happened and get back control again. So we will be able to work with our bodies and brains to regulate the stress response. So that's one thing we can do.

And if you're mindful and can really start to calm yourself down through meditation practices and mindful meditation, mindfulness meditation trains the brain to do this, trains our bodies to do this and to recognise. It's such a really important thing that we can do if we can practise that every single day.

The next one is movement. Again, it trains the body to respond and recognise the impact of stress. We recognise when our muscles are becoming tense and using the movement gets rid of it. It effectively tricks our brain into thinking we've fought the animal. There are just so many benefits to movement, and the evidence is so strong.

There was a report out today that talks about the economic impact of poor mental health in Northern Ireland, and good buys, good investments, to reduce that. And exercise is one of them. Exercise really works. It prevents mental illness from developing, it helps people cope with stress and pressure, it lifts our mood, and it keeps us well.

So a lot of other ones. Creative expression is so good for you as well. You don't have to get the guitar out, but singing, dancing, anything that you can do to bring that bit of joy back really, really helps. Crying, expressing our emotions, expressing our feelings.

My little 4-year-old is learning about feelings at the minute. Really good part of the curriculum where . . . And even they do it through little books and things. They learn about feelings, so they can learn to understand their own feelings, how they feel, what caused that feeling. If you don't know how you feel, you'll not be able to problem-solve your way through it. So you need to know the feeling first. You need to be able to label the feeling, and then understand how to deal with it.

And so many adults have not got the self-awareness to understand how they're feeling and then how they can modify that or change that or shift that. So that emotional intelligence is absolutely crucial.

And it's not about good feelings or bad feelings. All feelings are legitimate, and we need to be able to be self-aware enough to understand what the feeling is that we have, and then what caused it, and then how we address it.

Crying helps. Laughing helps, of course. And physical affection, touch helps. Again, that emotional regulation that we need to move from fight or flight into safe and social, that happens when we have human contact. It happens when we're in our packs. And it particularly happens between parents and children and partners. But people who don't have that touch have poorer wellbeing, have poorer mental health.

And of course, a lot of people missed that during the pandemic and that certainly has an impact. We're designed to live in packs and communities. The idea is that as animals, we've evolved to be able to go out and fight, but we're only supposed to do that once every couple of weeks. The rest of the time we're in with our packs, connecting again, and doing all the good stuff. But unfortunately, the modern world means that we've got stress every single day, so we don't have that.

And then positive social connections generally. We can't always do it in a face-to-face way, and in fact, there are benefits to the online stuff. But any sort of positive social connection, particularly if we can see the other person's face, is really, really good.

We have templates in our brain that are activated when we see smiles, when we connect with people. It supports emotional regulation makes us feel safe.

And there are mirror neurons that allow us to identify when others in our pack are friendly towards us and also allow us to pick up whenever there's negativity, whenever we're essentially in front of the enemy. Our brains have evolved to be able to do that.

But we need to be able to see other people's faces and other people's physical expressions so that we can have that emotional regulation, so that we can feel safe. So positive social connection is really important. And we'll return to all of these things at the end as well.

So what I'm saying here is we need to react to stress and change how we respond to stress. And this little diagram shows how we can find new paths and new solutions when we address the symptoms of stress in our body.

When we respond to the physical stress symptoms, we can find a space, we can manage stress, and we can find new pathways and solutions, and we can be creative, and we can connect, and we can problem-solve, and we can negotiate and compromise. All the things that we need for a productive, flourishing society.

It's about self-awareness. It's about being able to identify the source and cause of stress and find new solutions and calm ourselves down. So emotional regulation is the core of all of this, and dealing with the physical effects of stress in our bodies is fundamental.

Selfcare and Reflection

So moving on now to this little bit where I'm going to talk about what we should be doing more generally. There are some ideas about how to manage the effects of stress, but as school leaders, we want to elevate it. We want to move it up a gear. We want to really set goals. If you think of Maslow's Hierarchy of Needs, we're talking here about self-actualisation, moving towards the top of the pyramid.

So these are some things to consider whenever we're thinking about our own goals.

The first one is about establishing what our core values are and what our purpose is. Especially in a world that there are a lot of challenges and there's a lot for us to worry about right now, it's important that we identify the things that we can control, and the things that we can't control, and we know the difference there.

So to do that, we have to start with thinking, "Well, what is my purpose? And what are my values? What is my role in all of this? And how can I make a difference?" Once we've got that, we need to remind ourselves of that because we can very quickly sink under the weight of the world's problems and the stress of our own worlds and the stress that we see all around us.

So it's important to also to think about how our current coping strategies are serving us. What are we doing currently to cope with stress, and is that enough, and is it good for us?

Lots of us have built in things, like a bit of physical activity. But whenever I'm under stress and pressure, I tend to scroll on the phone. I tend to do mindless things, sit and eat biscuits at night and stuff, rather than going to bed. So what are we currently doing when the stress hits, when the tiredness hits?

And then prioritise our physical health, because our brain is a physical organ. It's through being in good physical health that our brains will work properly, that we will have that ability to stay calm in a really stressful situation.

So thinking about our own psychological safety, it comes with being physically well, having enough food, not reducing our food intake, but not eating too much either. And things like sugar and caffeine and stuff like that really does impact me for sure.

Sleep is absolutely fundamental. One thing I learnt in the pandemic is that I needed more sleep than I thought. And last night, I was looking there and I had eight and a half hours of sleep. So going to bed early is really important for me, but not for everybody, so it's different. But exercise, sleep, food, all of those things are important.

And we need to control our exposure to stress as well. We don't need to be looking at 24-hour news. I know teachers are all very busy in your various different roles, so you're probably not doing this. But I certainly was guilty of this at the start if the pandemic. I needed to know everything.

And even at the minute, I put on the radio a lot. I do a lot of 5 Live, listen about the war in Ukraine, but that's really stressful. So we need to manage that and do something else. Replace it with something else. If we're doom-scrolling, replace it with knitting or something. Just do something useful rather than expose ourselves to yet more stress that we don't need, that's not relevant to what our lives are about.

Practise cultivating the mind-set that you want. The neurons that fire together, wire together. I talk about gratitude a lot. But really, if we build in gratitude practice . . . I do a line a day. I do a bit of journaling every day, and gratitude is part of that, reminding me what I'm about and what I'm grateful for. It really does change what that automatic thought is whenever we're under stress.

And mindfulness meditation, again, helps us understand our own stress response and how we react. It allows us to take control of our thoughts, and to problem-solve, and to achieve our goals. So think about how we build in that to our everyday lives.

And think about our own self-talk. I'm big into Stoic philosophy at the minute, and one of the Stoic sayings is, "We suffer more in imagination than reality". So really think about what are those automatic thoughts that we have? Start to try and take control of them, because they do get in the way of us doing the good stuff, actions in line with our core values and our purpose.

So here are some ideas around the committed actions. How do we make sure that we devote our days to the actions that are important? Setting boundaries is really, really fundamental to all of us being able to say no. That could be about our finance, our time, balancing work and family. Absolutely crucial. But saying no has become an important part of how I get things done, and people aren't as offended as you think.

Creating safe spaces for ourselves and our families. Setting boundaries around screens. For all of us, setting boundaries around to what gets into our lives. Scheduling time to connect with our tribe is really, really crucial there as well. Mindfulness, gratitude, those situations where we have flow or creativity, music, art, all those things will help us with our committed actions.

And again, another lovely but quite sad thing that the Stoic say, "Live life as if you were a dying person". What is really, really important? And they would say that we all are dying people, so we should only do what's necessary and we should be really clear about what our goals are.

Leadership

So in the last couple of minutes, I'm going to talk about leadership. So this is going to be quite quick, but I use these little meerkats and one of the heads has been cut off. That's not really good, is it? But I use this analogy to remind us that we are a social species and you guys are the leaders of the pack. We have neuroception. We're tuned in to each other.

We're mammals, but we're designed to live in packs. But we're all looking to the pack leader to tell us whether it's safe. And we'll know by the look in their eyes, by the way that they present themselves, if there's danger.

So if you as a leader are in a state of danger and fight or flight, if you're stressed, everybody else will pick that up. But if you're calm and well-regulated, then that's contagious, too.

So self-care is leadership, and leadership is self-care. It starts with your self-care. It starts with how you manage your own response to stress, and how you problem-solve, because your ability to do that is going to influence how you can do that with other people.

So the three pillars here are self-awareness and self-care, and listening and invalidating, working with your pack, really hearing what they're saying. You can't do that if you're angry and aggressive and looking and trying to blame them about stuff and you're all up there. You need to be well-regulated, you need to listen, and you need to validate and make sure that they feel heard.

And it works the same with little kids. Just understanding what the problem is, even if you can't sort it out, it tells them, "I hear you", and that helps so much. It calms them down. At least you know, because you've got the power as a leader, or at least you're perceived to have the power.

And then you have to problem-solve with them, but not for them, because you can't live other people's lives for them. You have to give them back the power. But if there's something you can do to make life easier for them, then you need to hear it and work with them so that you can help them with that.

I think this ABC model of leadership is really, really useful. It starts with autonomy and power and control, belonging is the second bit, and the final bit is contribution.

So people need to have autonomy. They need to feel that they have control over their own life. Thinking back to the pandemic and the young people and the children, what was so bad about their experience there was that they didn't have control.

And people need to feel they belong, that they're part of a community, that they're cared for and valued. Again, leadership is about that connection. Brené Brown calls this "daring leadership", daring to connect and care about the people who work with you. And once you do that, then that link that you have with them means that they will work better, and work for you, and work with you. But they need to feel that you care, and they need to feel respected and supported.

And then the final bit is that everyone needs to see their contribution. They need to see how this work fits with their sense of purpose, with their goals. And you need to work with them to ensure that their contribution is felt and that they're regarded well.

I came across this idea of constellation leadership, which aligns very nicely with trauma-informed practice, which starts with equality and transparency and all of that stuff. So all of the things I've been talking about actually fit with the trauma-informed model. Even that all stress response thing. It's all about being trauma-informed.

Understanding that poor mental health comes from stress and pressure and all of those things, and that being trauma-informed means we need to create psychological safety so that people can be in that safe and social place.

So constellation leadership is this idea of the workplace is kind of like a sky with lots of different stars. And as leaders, your job is to draw the stars into constellations so that you can achieve the outcomes that you need to achieve. It's not about hierarchies. It's really about recognising who your stars are and how your stars align to create patterns that can achieve what you want to achieve.

Five Steps to Wellbeing

So I'm going to just flick on to the end. One of my jobs, of course, is around the mental health strategy. We can talk about that later if you'd like to. But this "take five steps to wellbeing" is really, really important.

Part of my work is to try and support the whole population of Northern Ireland to keep well, and these are five actions that have been proven through the research that really helps us keep well, avoiding mental illness, but also achieving our goals, having a purpose. So it's not just about wellbeing. It's about self-actualisation.

First one is to connect. Connect with other people. It keeps us well, keeps us regulated. Connect with our pack. It helps us cope with stress. We're designed to do that.

The second one is to be active. It's the physical activity.

The third one is to take notice. So that's your mindfulness. That is about being aware of your body, how it's responding to stress, taking notice of our environment, being in the moment so that we can listen, so that we can hear what people are telling us, so that we can live right now in the present, so that we can give back.

And fourth one is to keep learning, because that curiosity drives us. People who are curious and conscientious . . . those are the two attributes, the two Cs, that predict who will flourish, who will achieve their goals.

And the final one is to give back. That's fundamental to our sense of purpose. There's lots of evidence that even when people have lots of money, it's when they're giving it away, it's when they have a sense of giving back that they really feel good about themselves and lead a good, purposeful, meaningful life.

And you're doing that every day of the week in your roles as school leaders. You're giving back to your school community and a generation of young people, and you should be really, really proud of that and remind yourself of that whenever the stress and pressure that you're all under starts to feel overwhelming.

So I'm going to leave it there, and we'll see if there are any questions. I always go over time a wee bit.

Graham: Professor O'Neill, thank you very much for that. That has been great. There's lots there, which maybe we'll be able to unpack over the next couple of minutes through questions and answers.

I'm going to disappear from your screen in just a second, and Elizabeth and Nicola, whose pictures are on the screen at the moment, are going to facilitate a Q&A. People have been putting questions into the question box during the presentation and they're going to come now and put those questions to you.

And then when they're finished, Robert Wilson, the regional officer, will come and bring our session to a close. But once again, on behalf of the Association, thank you very much for this afternoon. Nicola and Elizabeth?

Elizabeth: Hello. Thank you again, Siobhan. That really was super this afternoon. If I maybe kick off with a question that I have on the school perspective, and then follow up with one that has come from one of the attendees. It was the first one in, which was superb.

But I start off just with the school one. So during lockdown, pupils and parents were obviously working from home, and screens and screen time became a significant comfort, or should we say maybe comfort blanket, for our young people.

Have you any advice as to how we break this cycle of dependency and maybe help our young people, I suppose, reengage with socialising?

Siobhan: This is really important. First of all, I'm a parent and we had the iPad out, and it's a nightmare because she's only 4.5 and there's a whole row getting it off her. So I would use it to get a quick meeting done, and then trying to get it back again is huge. It causes so many rows. So it's not what they're doing when they're on it, but they get so engrossed in it and so caught up in it.

This is what I'm doing in my world. I've stopped the YouTube videos for her and it's only games that I have selected that are on her devices now. So at least I know what she's doing and it's vaguely educational.

But there's no evidence that screens per se are the problem. Don't panic. That's the other thing. But just really open up opportunities to do great things that aren't on the screen.

Especially those older children, teenagers, they do connect with their friends. They need that access. Imagine that somebody took away your phone. I would be freaking out. So it's about trying to give them . . . It's like the carrot or the stick. I would be going for the carrot here, giving them a lot of things to do so they are not bothered about their phone. So lots of opportunities to connect in real life.

That's why those summer programmes were so important. And we need to be doing that again this year, getting kids back into things that really engage them, the physical activity, the art, the creativity.

So it's presenting them with opportunities to do things that can compete. And it's very hard to compete with the World Wide Web. I recognise that. But it's getting them into something that really fires them up and keeping those lines of communication open between parents and children and trying to avoid the battles.

I just switch the internet off, but she's getting wise to that as well, when I need to stop it. It's just hard.

I think the relationship that you have with your child is fundamental, so try and keep that relationship really good. Your role is to provide boundaries for the child too, and that's important. But if you can try and stay connected and keep connecting with your child. If it's a younger child, play is crucial. An older child, just opportunities to connect, to chat about stuff. I think that's the best we can do as parents.

And get interested in what they're doing online. What are they looking at? Ask about who's where. Find out what their online world is like and what they're looking at. And just try and set boundaries and create boundaries and shape boundaries. But give them other stuff to do if you can, if you have the options.

And those universal interventions that get the kids back playing again, the community events, I've been supporting those. They're very, very powerful. The play parks, the games, the sports, all of that. Everything that we can do to get them connected with their friends in real life, and then gradually that will start to rebalance.

But the online stuff is part of our world. The screens are there. We need to just learn how to help them manage it and navigate it and give them the problem-solving skills and model good regulation ourselves.

So if we're sitting at our phone . . . I'm guilty of this. She lifted it out of my hand this morning in the bed. If we're sitting on our phones all the time, they're going to just do that too. And who would blame them? It's good.

So hopefully that helps a bit.

Elizabeth: Okay, thank you. I'm just going to ask you the first question that came in, and then I can hand over to Nicola. So it says,

"My daughter is 5 and struggled greatly during the lockdowns. How do I know what challenging behaviours she is displaying are part of her normal development, and what could be indicative of an on-going mental health difficulty?"

Siobhan: It's a really difficult one to answer without . . . And even then, I'm not a clinician. I know my daughter is nearly 5 and she really struggled. She was in her playgroup with all her friends, and she was an only child, and just taking her out of that situation, they're going to struggle. If you're struggling a bit too, they'll pick up on that as well. But that's normal.

So I think if the behaviour is so bad that she's harming herself, or if . . . There are little checklists that you can use. There was one that our playgroup sent around. If they're not able to connect with their friends again, if they're not sleeping, if they're not able to eat, things like that are quite worrying. But tantrums at that age are completely normal. So it is really difficult.

But what I would do is actually ask the teacher, ask the person in the playgroup, "How are you finding her compared to other kids?" They'll be able to tell you. Have that honest conversation. So that's actually what I would do. And go to the toddler groups or connect with other parents and you'll soon get a sense of that.

But I think the teachers and your health visitor is also there, so talk to them. Don't shoulder this alone. But know that a certain amount of externalising behaviour is very, very normal.

And one of the few symptoms my child had with COVID was that she was really dysregulated when she was tired, and she was shouting and screaming and kicking things. I was like, "This is really . . ."

She's normally quite bad when I pick her up from childminder because she's been bubbling under all day, and now all of a sudden I'm there, and it's like it all just comes out because I'm her safe place and she can express that. But she was even worse. But that was a symptom that she was suffering and she was struggling. That's the only way they have of communicating.

Talk to the teachers, basically. Talk to the people who are there, and just watch it over time and talk to your doctor if you're worried. But a certain amount of that is normal and it's not going to damage them for the rest of their lives, because they get back in with their friends and their brain sort of starts to reset again, and they'll be okay.

Elizabeth: Nicola, if I hand over to you maybe.

Nicola: Thank you, Elizabeth. And thank you, Professor, for this afternoon. Apologies, first of all, we have a number of questions in, so we may not get to them all this afternoon. But the first one would be you mentioned the mental health strategy.

How do you think that will help us as school leaders and school practitioners?

Siobhan: Mental health strategy is really important because it's . . . The framework for improving mental health services, so all the improvements that we need to mental health services, are in that strategy.

But also there are early intervention and prevention actions there. So that is about joined-up working, so it'll be working with early years, with schools. It's just identifying at an earlier stage and being able to get help quicker for children and young people who need that help.

And it's also an increase in the budget for child and adolescent mental health services and an improvement to those services. So all of that should make a difference, but we need to implement it, and we need the money to implement it too.

Nicola: Thank you very much for that. And then one from . . . just read out a very current one.

Siobhan: Sorry.

Nicola: Are you okay?

Siobhan: Yeah.

Nicola: I saw a letter where a reader said she just got over the fear of COVID and now there's the Ukraine crisis, which has sent the child into a downward spiral again.

Any thoughts on these additional stresses that now people are trying to deal with, especially younger people in our population?

Siobhan: It depends on the age that the child is. But certainly, for younger children, I would just not expose them to images of war. It's just too difficult. Joanna Fortune, who's one of my parenting gurus, she's brilliant. She does lots of podcasts and things. But she says under 7, really, they don't need to know about this stuff. But older children certainly will need to know about it.

I think it's important to listen to what their fears are about, to find out exactly what they're worried about. So have they heard about food shortages here, and the increase in fuel? Or is it that they're worried about the war coming here or that they'll be sent away? Or is it that their schools will be closed?

So you need to hear what they're saying, and then answering their question and making sure they understand the answer.

The reality about Ukraine is it's happening a long way away and we need to put that in perspective for them. There are other wars that have been happening for years in this world that we didn't know as much about. So this is part of life, too.

And it may help that they understand even on a map where Ukraine is and talk through what's happening. Try and be positive and be hopeful about this because there are on-going talks. There are a lot of people, very, very smart people, who are trying to sort this out.

So we've got to try and remind them of all the good things, and make sure that they feel psychologically safe at home and they know that their little worlds aren't going to be disrupted, for now at least and not for a long time probably. So we need to keep it real for them.

Their schools were closed before and that has left them now the feeling that . . . And anything can change at any minute. So we need to give them that safety and stability and make sure that all their activities are going on, and their relationship with us is really strong and that we're not freaking out about it or talking about it all the time ourselves too. We just have to manage this.

Nicola: Thank you very much. I think probably, Elizabeth, just one more question and that's going to be us and our time.

Elizabeth: Okay. If we just move to the next one, then. So you did mention that the boys in particular, which certainly would be my context here so I was curious when I saw this question come up, tend to act out when dealing with stress, which I would agree with and we see. So the question is

"Does that stress response change as they get older, as men stereotypically find it harder to talk about how they are feeling?"

Siobhan: I think there's a generation of us who have not been trained in the way of recognising our feelings and identifying and labelling them. And talking about them can be part of that. We don't necessarily need to talk about them, but we do need to know how we feel. So there's a whole generation who've never talked about it, who have no emotional literacy or mental health literacy in a sense, and males were discouraged from doing that.

We don't give little boys dolls. We know that girls' emotional intelligence and social skills improve because of the toys that they're given at an early age, and boys don't get that. I think boys really, really miss out. So we need to start changing that.

And as men get older, they learn and they're rewarded for not talking about feelings, for pushing everything down, and in a sense they're taught to be brave and be fighters. So that's what they do and that's what they see around them. That's what they see in their cartoons and their films and the media and everything that they're fed. So it does changes.

I know the wee boys in my world, Annabel's wee cousins, they're very sensitive, and they're exactly the same as the girls, but it nearly gets knocked out of them by the time they're just a couple years into primary school. Their behaviour gets very different, and they orientate themselves towards a different way of being. And my concern is that turns them off from speaking about their feelings.

But we're living in a world where we've got footballers and pop stars and all sorts of people starting to say now, "You know what? I was struggling", or, "I feel a particular way". So there are really good role models.

And the male teachers are really, really important in this as well so that they can help our young boys with their emotional literacy, and allow them and permit them to discuss their feelings, particularly feelings that are negative feelings. We know that there's no such thing as a negative feeling. It's how you're feeling and that's okay. Now what are we going to do to change that? How are we going to manage that?

But it's the first step, self-awareness, awareness of how we feel, that is so important. We must work more to do that with little boys, and we need to change how we do those social and gender stereotypes as well. I'm very, very strong on that.

And wee girls as well. We need to start to change how . . . Because they don't get the stuff that boys get that improves their mathematics and all of that as well. So it cuts both ways.

Gender stereotypes are harmful, and they harm people's mental health. And that's why our male suicide rate is the way it is, because so many men never ask for help, and their response is an externalising response to a situation of crisis and they harm themselves, and then we see the deaths and it's just devastating.

Elizabeth: Thank you.

Robert: Far be it for a man to interrupt three women, but, Professor O'Neill, can I on behalf of ASCL and all the attendees here today say a very big thank you to you for the presentation that you've given us, and also the clarity in the question and answer session?

Can I say thank you to Graham, to Elizabeth and to Nicola who all have been involved in today's event? It would be remiss if I didn't thank our friends in Legal-Island, in particular Rolanda and Scott. And of course, to our delegates, thank you for attending.

A couple of things to draw your attention to. On 23 March, there will be another joint Legal-Island/ASCL webinar focussing on the Children's Code and what it means for online services. You should be getting information about that, if you haven't already received it.

And then over the next number of months, ASCL Northern Ireland plans to run a series of seminars focussing specifically on school leadership issues. So we're hoping to kick that off at the end of April, early May with the Chief Inspector.

We hope to run a pension seminar for our members. And that's not just for people who are getting close to retirement, but those who are at earlier stage who are planning for their retirement.

So watch this space, and there will be more information available to our members on that.

If you're joining us today, you're a school leader and you're not yet a member of ASCL, you would of course be very welcome to join us. We're a very large, independent trade union and professional association. And if you would like more information, please contact any of the speakers, Elizabeth, Graham, or Nicola, who were on stream today, or contact me at robert.wilson@ascl.org.uk.

Thank you very much, folks, and have a safe journey home if you're still in school. Bye for now.

This article is correct at 03/03/2022
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