Mental Health Care at Shanti Home
Mental Health Care at Shanti Home

INTRODUCTION:

 

It has been established that the major risk-taking behaviors in terms of Health and Mental Health in early childhood and adolescence. School plays a very important role in these years in overall development and shaping of the personality. It is observed that children come to school each day with more than their lunch and backpack. They bring a myriad of life factors that shape their learning and development. School is the place where the child gets the first experience of learning. It’s also at school that many problems; educational, social, emotional and psychological come to the fore. Thus, schools have to integrate basic life skills and health promotion strategies as part of the curriculum.

 

While most schools today avail services of a   or a full-time counselor, or network with a Mental Health counseling center to provide counseling services to the students, the mental health needs of today’s schools extend far beyond that. Good mental health is not simply the absence of illness but also the possession of skills necessary to cope with life’s challenges. Life skills education through the School Mental Health Program is therefore considered one of the effective and necessary tools to sensitize teachers as well as students regarding mental health and wellbeing.

 

Shanti Home Advanced Deaddiction, Mental Health Clinic, and Psychiatric Rehabilitation along started its School Mental Health Program in 2013 for Gautam Budh Nagar District, Greater Noida. In the initial phase of the program, private schools were targeted. Both teachers, as well as students from different age groups, were included in focus group discussions to understand the common problem areas and difficulties. Collateral information was also obtained through individual interactions with other health practitioners, RWA members, children and parents attending OPD services as well as school counselors working in these schools. The information obtained was categorized and further analyzed for understanding common themes and difficulties, frequently expressed needs, challenges/blocks, current services available, help-seeking patterns.

 

COMMON OBSERVATIONS:

 

Though the majority of the schools were aware of the Mental Health need, many did not have regular counselors. Non-availability of experienced counselors was a major drawback. School teachers were found to be sensitive and were able to identify the problems at an early stage but the convincing parent was reported as difficult task and referral for Psychiatry assessment was reported to be even more difficult. In identified cases with SLD, ADHD teachers felt helpless due to lack of facilities and training to deal with these issues. Behavioral problems were the major concern for the teachers in primary sections.

 

In higher classes substance use disorders, self-harm behaviors (particularly wrist cutting behavior), internet addictions, involvement in bullying, antisocial acts were reported as common problems.

 

Interaction with the students from the secondary section revealed drug use as a major concern. As per students most of them were aware of various drugs of abuse and even shared their experiences about the ease with which these drugs could be obtained in their locality. Nicotine and Solvent use was reported to be a major problem. Quite a few reported having started with alcohol as early as 14 years.

 

Besides these, feeling moody, irritable, facing generation gap with parents and teachers, not understanding their stress level, family problems, relationship problems, feeling burdened with expectations, too many classes with no free time, need for being accepted by peers, concerns and apprehensions related to body and sexual urges, attractions were the other themes. Internet addiction and cyberbullying were also one of the concerns raised. One noteworthy point was, like teachers, students from different schools reported resorting to self-harm behavior particularly wrist cutting as one of the coping they learn from their peers to deal with frustration and is considered “cool” by quite a few.

 

It was also reported that a significant number of parents belonged to the rural background with expertise in agriculture, property dealing, and business and found it challenging to keep pace with the modern education system requirements. Many expressed difficulty in helping their children and relied mostly on schools for their overall growth and performance. In other cases, with both parents working, they expressed difficulty to have quality time with children. The overall understanding was that the children and parent interaction seemed minimal. It was also noted that very few actually sought help from mental health facilities. Stigma, fear of a child being labeled for a lifetime, hesitation to start medicines at an early age, not getting “good” counseling services were some of the reasons for not taking help.

 

STARTING OF SCHOOL MENTAL HEALTH PROJECT:

 

Two years of the intake assessment helped the team to prioritize the problem areas and needs. It was considered that the adolescent group needs to be targeted more intensively. Also, the team was aware that the understandings were based on the observations from private schools which do have basic awareness as well as access to mental health services and facilities. The problems in Government Schools may be more intensive and different in terms of needs and priorities. The team, therefore, felt the necessity to start a structured school mental health project for the district preferably targeting the Government run secondary schools. Initially, CEO Gautam Budh Nagar was approached to map resources for initiation of the project. With all the necessary groundwork. Directorate of Education, Gautam Budh Nagar was approached for permission to start the project. After a few rounds of discussions with concerned authorities, permission was granted to initiate the work in 14 schools in the first phase. Out of these, 11 were Government secondary and senior secondary schools and 3 were private convent schools.

 

The objectives were:

  • To sensitize and orient teachers to help and recognize mental health and behavior problems.
  • To sensitize students about relevant mental health and psychosocial issues.
  • To promote life skills as abilities for adaptive and positive behavior.
  • To increase awareness of mental health issues among parents.
  • To initiate and maintain dialogue between students, teachers, and parents.

 

About 4000 students in the age group of 12-16 years were covered under this school Mental Health Project over a span of two years. Cascade strategy for disseminating life skills education was used based on the resource module prepared as part of Delhi School Mental Health Program Model “Experience” (with technical support from Ministry of Human Resources and NCERT).

 

Activities at a glance:

  • Orientation workshop with school teachers.
  • Mental Health Awareness talks for parents.
  • Workshops on Life skills and Mental Health with students.
  • Developing a ‘Peer Counselors’ network as a link between students and teachers.
  • Various group activities including essay competitions, slogan writing, poster making competitions on various themes.

Both teachers and students groups participated actively in all activities. Interaction with parents was also found to be useful. Participants showed their curiosity and concerns towards knowing about Mental Health and other related aspects by raising queries pertaining to improving attention, concentration & memory, tackling exam stress, relationship issues: family conflicts and breakdown, growing up and concerns, managing depression, cutting and self-harm and suicidal thoughts, anger, violence, delinquency, bullying, phone addictions, school and study problem, pressure to do well in school, body image and self-concept problems, substance use/abuse.

 

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