‘Mental health professionals should be on the spot, in the schools where students are

Monday

It was a busy day. A colleague made me aware of two students who were self-harming.

This is more common than you might think, but the culture in this school allows students who are worried about a friend to approach any of the teachers, usually myself or the other staff psychotherapist, Marie Nolan.

Family issues came up with more than one student today. I see four or five cases a year where parents are separated but for financial reasons still live in the same house. There may not be huge fights but the constant snide remarks, dirty looks and little put-downs can get kids down. Some vulnerable teenagers in that situation self-harm.

These kids can be afraid to say anything to parents in case it makes things worse. Teenagers often don’t tell their parents what is going on because they don’t want to worry them. Sometimes, they don’t know how to put it into words and want someone else to tell for them.

When I offer to speak to parents, I am often struck by the relief on the student’s face. Occasionally, a kid will beg me not to contact their parents so in a situation like that I ask if I can talk to an aunt or an older sibling.

I see a lot of second- and third-year students. Kids in that 14 to 16 age group seem particularly vulnerable – more so than Leaving Cert students, which is probably surprising.

Girls tend to cut themselves more than boys. Girls internalise their problems, they cry, get stomach aches and cut themselves, sometimes very badly, where nobody can see the marks. Fellas will get into a fight, or they might start hitting walls.

Financial worries are causing stress in families and we see the effects in school where students are worried, insecure and really anxious about their parents. Eviction has become an issue. Families get evicted, maybe end up staying with a relative, their kids feel in the way, they don’t have space, nowhere to study. They can’t sleep, so some come into school exhausted and frustrated because they can’t get their homework done.

I spent a long time today liaising with a social worker about a student who has been referred to the Child & Adult Mental Health Service (CAMHS). Confidentiality is crucial in my dealings with students but they understand that if they harm themselves or others, parents will be notified and referrals made to a GP or CAMHS. A lot could be done to improve communication between schools and social services.

Tuesday

A parent rang me today because her child is worried about friends who are writing on Facebook that they want to die. Students often worry about what friends put up on Facebook. Sometimes students start to self-harm because of worry over what someone is threatening on social media. They don’t know who to tell and they are terrified to go back online in case their friend has suddenly stopped posting. It could be a friend whose family has emigrated, or a kid they met on holidays, or maybe someone they met online.

I had a situation where a group of six friends were cutting themselves. It started out with a small group trying to support a friend who was self-harming. They couldn’t help and out of frustration or as a way of relieving the worry, they started to cut themselves. A parent spotted something on Facebook and alerted the school. Having trained counsellors on site in a school takes a lot of stress off students, parents and other teachers when these problems arise.

I spent four periods today teaching transition-year students. I also spent part of the day touching base with students who were seen last year, to check if further counselling was needed.

We have “peer mentors” in every year, students who alert a teacher if they spot anyone in difficulty. It’s a great system – they have no qualms about telling me or another teacher if someone has a problem. There is also a culture in the school where it is okay to go to the counsellor for a chat. There is no stigma. Last year, myself and the other counsellor saw 119 kids out of a student population of 950. The gender breakdown is about 50:50 but there are slightly more girls.

A peer mentor came to me today after noticing something worrying on Instagram so I will check that out.

It was a very depressing post.

A lot of meetings today, including one with Marie, the other school counsellor, to discuss students and treatment plans. The school “care team” meets every two weeks. It’s a chance for the principal, careers guidance teacher, chaplain, year heads and counsellors to catch up.

Wednesday

A student has been writing on Facebook about being depressed so I will follow up.

A lot of the kids I see are self-referrals. The counselling service has been in place at St Peter’s for about 14 years. Between the two of us we provide about 35 hours of counselling a week. We are both accredited by the IACP (Irish Association for Counselling and Psychotherapy).

Teachers have a golden opportunity to spot a student in difficulty, so it’s not surprising that 41 per cent of referrals come from other staff and 38 per cent from students themselves. About one in five is referred by parents. A counselling session lasts for 40 minutes. Students come to my room. Some keep coming every week throughout the school year and some just see me a few times.

In recent weeks I have been meeting first-year classes, explaining that we regard “seeking help” as a subject on the curriculum.

Thursday

I met a child who has an eating disorder and does not want to go to the CAMHS. I could write a book about this. In my view the mental health professionals are good at dealing with under-12s and over-18s but there is a big gap there for teenagers. That’s why Jigsaw was needed.

A lot of the students tell me they find the professionals patronising. They always take the parents’ side. I tell them they have a right to demand that their mother or father is kicked out of the room when they are speaking to a counsellor. A 16 year old may not say what is really on her mind if her mother is there.

I often discover when a troubled student sees me that it is actually the parent who has the problem. Children describe things – odd behaviour, irrational screaming matches, a parent who drinks all night. A child who has to clean up their mother’s vomit before coming into school is not going to be able to concentrate.

There are kids who go home to a cold house where there is no dinner, no food in the fridge. Sometimes a kid tells you their mother hates them and if you probe it might be obvious that the mother is depressed. You can at least tell the kid “it’s not your fault”.

I can advise students how to not escalate the situation at home by, for example, not shouting back. A 15-year-old child is sometimes the only adult in a house.

Friday

I had a meeting with the principal.

A student approached me on the corridor and said she needed to talk. These chats can be about anything from self-loathing because of poor body image to someone who is being bullied. Usually it’s enough to call in the perpetrator and point out “that’s bullying” and they will stop. Girls are told “you’re fat” or are called “a fat bitch” and guys are told “you are gay”.

Sometimes a boy who is gay is isolated because the other guys don’t want anyone to think they are gay. We are very supportive of LGBT in this school and don’t tolerate discrimination.

I see students who have ADHD (attention deficit hyperactivity disorder) or ADD (attention deficit disorder). A kid with ADHD can be disruptive in class. I find parents are often very resistant to medication but it can really help. A child who is bright can get a huge kick out of suddenly realising that they are actually good at a subject.

The issue raised most by students who see me is “parent/family conflict” (60 per cent). Other big ones are problems with authority, drug abuse, bullying, parental depression and student depression. Nine per cent of those who receive counselling are self-harming, and 2 per cent are sexually abused.

Not surprisingly, some students have a number of stressors. A kid who is acting up in class may have problems at home. Five students one year had 10 stressors. It is probably a good indication of why mental health professionals should be on the spot in schools, where the students are.