Student mental health and wellbeing in Victorian schools

John Graham

Schools have been identified as both a significant source of stress for many young people, often leading to symptoms such as depression and anxiety outside the normal range, and as an important site for the promotion of mental health and wellbeing, including coping with stress.

They are the central point of contact with both those who are currently experiencing mental health difficulties and those who may be vulnerable to such difficulties in the future and are often where symptoms of mental disorder are first identified.1

The Black Dog Institute/Mission Australia 2012 – 16 surveys of young people aged 15-19 found that school or study problems ranked as the second most important issue of concern for those with a probable serious mental illness (behind coping with stress and ahead of depression). In 2016, 59.6 per cent of this group nominated school or study problems as something they were “very” or “extremely” concerned about. This was compared to 31.4 per cent of those who did not have a probable serious mental illness. The survey also found that young women (65.9%) had a greater prevalence of concern about school or study problems than young men (47.6%).2

In 2016, just under one in four young people aged 15-19 years of the 22,000 who responded to the Mission Australia Youth Survey met the criteria for having a probable serious mental illness. This represented a significant increase in the proportion of young people meeting this criteria over the five-year period 2012 (18.7%) to 2016 (22.8%).3 In the most recent Mission Australia published survey (2018) of 15-19 year-olds, when asked to nominate the most important issue in Australia today, 43 per cent of the 28,000 respondents nominated mental health.4 It was the most important issue for survey respondents in 2018 up from being the third most important issue (20.6%) in 2016. 

While young people in the 15-19 age group have the highest likelihood of developing mental illness, and the proportion of those meeting the criteria for having a probable serious mental illness rising from 20.8 per cent among 15 year-olds to 27.4 per cent among 18/19 year-olds, it is now accepted that the underlying predispositions for mental disorders are shaped during childhood and that 50 per cent of mental health disorders begin before age 14 years and continue into early adulthood.5 The federal government’s 2015 study of the mental health of children and adolescents found that 6.9 per cent of children aged 4 – 11 had anxiety disorders.6 It has also been found that some groups of children and young people are disproportionately affected by intentional self-harm and suicidal behaviour: Aboriginal and Torres Strait Islander young people, lesbian, gay, bisexual, transgender and intersex young people, young people in out-of-home care, young people with a disability, and young people living in rural and remote areas.7

The level of concern about the rising incidence of mental health problems among secondary students was highlighted by the response of principals to an Age inquiry at the end of 2018. One principal told the reporter that at their school the number of students presenting with depression or anxiety rose from 285 in 2015 to 743 in 2017. The school also supported 298 students who were experiencing suicidal ideation or serious self-harm in 2017 compared to 47 in 2015.8 Untreated mental health issues were related to poor attendance, disengagement, and poor relationships at school and home.

High stakes testing and examinations

There are a number of specific school-based factors which have been linked to student mental health issues. Of particular concern is the stress created by high stakes testing and examinations. The impact of high stakes whole cohort testing (NAPLAN) in primary schools (Years 3 and 5) and lower secondary (Years 7 and 9) has negatively affected the wellbeing of many students. A teacher who completed the AEU mental health survey in June expressed a common concern among primary school teachers about the effect of the testing on young children: 

Students have asked me if NAPLAN will affect their high school applications and if it will affect their university applications. Many students lose sleep at night and I have had parents tell me that their children don't want to come to school during NAPLAN time. This is all during primary school years. News outlets also directly cause students to worry as they watch the news reports about NAPLAN data.

The Whitlam Institute/Melbourne University study of the impact of NAPLAN used a survey of 8,000 teachers across Australia to identify, among other things, the health and wellbeing issues for students involved in the testing. The study found that survey respondents stated that some of their students reported feeling stressed, a concern that they were too ‘dumb’, fear of parents’ reaction to test scores, feeling sick before the test, freezing during the test, sleeplessness, and crying.9 These findings are consistent with a range of other studies in Australia, the United States and the UK which link high stakes testing to concerns about student mental health and wellbeing. 

The impact of the Year 12 examination system on student wellbeing and mental health has been an ongoing concern of teachers, parents and mental health professionals for a long time. This concern has been exacerbated more recently by evidence of increasing mental health issues in the senior school age group. One former Year 12 student indicated the pressure felt by vulnerable students faced with the high stakes exam environment: I felt like I'd failed at life. I contemplated suicide after I left school and really the only thing that kept me here was understanding what that would do to my parents.10 Psychologists have pointed out the link between the timing of final exams and the age when teenagers are at their most vulnerable and often struggling with their mental health for the first time.

"We know two very important things. One is that this age is the peak onset period for mood and anxiety disorders and we also have robust evidence that shows the prevalence of depression is increasing in younger people. We also know that if someone already has mental health issues that acute stress can precipitate even more serious mental illness or a deterioration in their mental health. So, it would be great to see a consideration of other methods of assessment that reduces a really acute period of stress around exam times."
– Associate Professor Chris Davey from Orygen, the National Centre of Excellence in Youth Mental Health11

67.8 per cent of respondents in the AEU mental health survey who were teaching VCE said that they had students with mental health issues in their classes and 85.2 per cent agreed or strongly agreed that mental health/wellbeing issues (identified in the survey) had negatively affected student learning at their school. One VCE teacher commented on the dilemma that they faced in 2018 which had implications for their own mental health as well as that of the students in the class. 

Last year, in one VCE class, I had 16 out of 20 kids on recognised mental health plans. It was overwhelming to deal with the volume of these students during a 'stressful' year. I nearly left teaching and for the first time in my career (28 years) was diagnosed with Anxiety. Teaching is such a different landscape and mental health issues are appearing in far greater numbers than ever before. 

AEU Mental Health survey

The AEU Mental Health survey, carried out in June of this year, received 2,972 completed responses from teachers, principals and education support staff working in Victorian public schools. The survey asked respondents about their awareness of student mental health issues in their institution, the impact of mental health issues on student learning, the level and accessibility of support – initial teacher education, professional development, employment of support personnel and access to mental health services.

The survey results present a picture of high levels of observed characteristics related to student mental health concerns and a strong view that mental health issues are having a negative impact on student learning. Respondents were asked whether they had students with mental health issues in the classes they were teaching. The ‘yes’ response for each school sector was: 41.2 per cent primary schools, 65.6 per cent secondary schools, 49.6 per cent primary-secondary schools, 40.5 per cent specialist settings. A further question asked respondents to indicate whether a series of specific issues related to mental health had affected student wellbeing at their school (Table 1). 

Table 1: Percentage of school staff agreeing or strongly agreeing that the following issues had affected the wellbeing of students at their school

Anxiety 95.7%
Challenging behaviours 92.7%
Family and/or parenting concerns 90.2%
Friendship and peer relationships 89.3%
Self-esteem 86.4% 
Anger management 84.4%
Trauma 72.9% 
Depression 71.4%
Bullying 67.6%
Child safety and protection 61.5%
Self-harm 51.7%
Drugs and alcohol 44.2%
   

There was a significant difference in most of these areas between low and high SES schools (see Table 2). For example, school staff at low SES schools were far more likely to report that student wellbeing at their school had been affected by child safety and protection, trauma, drugs and alcohol, anger management and self-harm

Table 2: Percentage of school staff who report issues have affected student wellbeing by SES rating and location

 

Low SES

Average SES

High SES

Metro Melbourne

Large regional centres

Child safety/protection

74.8

56.4

39.9

68.9

73.8

Trauma

85.4

68.0

53.3

68.9

86.6

Drugs and alcohol

57.0

36.7

27.7

39.3

58.2

Anger management

91.7

82.0

67.7

81.3

91.2

Self-harm

61.8

47.4

38.6

51.0

65.7

Another significant variation in the reported incidence of mental health issues between schools was their location (see Table 2). This applied particularly to differences between schools in large regional centres and schools in metropolitan Melbourne. School staff in large regional centres were more likely to report the incidence of each of the listed mental health issues than staff in metropolitan schools.

The high incidence of student mental health/wellbeing issues in schools reported by survey respondents is not only of major concern in its own right but also raises questions about how these issues are affecting student learning. The survey asked school staff to respond to the following statement: Over the last year student well-being issues have negatively affected student learning at my school (Strongly disagree, Disagree, Neutral, Agree, Strongly agree). The percentage of survey respondents who agreed or strongly agreed with the statement for each school category was very high - around or above 80%: All schools (80.1%), primary (78.6%), secondary (81.7%), primary-secondary (79.0%), specialist settings (81.5%). The impact on student learning of mental health issues differed according to the SES background of schools: low SES (85.2%), average SES (77.4%), high SES (73.7%).

Access to Student Support Services

Having managed students back into school after severe self-harm the mental health advice from the adolescent mental health institutions has been woeful. (Metro secondary school)

The front-line support for students with mental health issues in all schools is the classroom teacher, both through their day-to-day interactions with students, and the relationships and trust they build up over time as part of their teaching role. The Mission Australia/Black Dog Institute analysis of the 2016 survey results of 15-19 year-olds with probable serious mental illness found that 30.2 per cent said they would go for help to a teacher and 30.5 percent to a school counsellor. In addition, 37.9 per cent of young people without a serious mental illness said that they would go to a teacher for help while 31.3 per cent would go to a school counsellor. 

The AEU mental health survey asked teachers about the two areas where they may have received training and professional development for this role – initial teacher education and professional development. Only 7.2 per cent agreed that their initial teacher education had been useful in identifying and supporting students with mental health issues. Around half (49.7%) of all respondents said that their school supported their participation in professional learning activities linked to student mental health concerns.

The most common form of in-school specialist support for student wellbeing and mental health is Student Welfare Coordinators (SWC). 64.9 per cent of schools said that they had an SWC: 83.9 per cent of secondary schools and 48.3 per cent of primary schools. In addition, 41.5 per cent of respondents said that their school employed a qualified psychologist/counsellor. Melbourne metro schools were far more likely to employ a psychologist than regional or remote schools. When asked what additional resources are required to improve support for students with mental health concerns many survey respondents opted for the employment of a qualified psychologist at their school. 

External mental health support services were seen as inadequate by most survey respondents. 

The support services provided by the department are poor - the staff members constantly change, don't know our school, and demonstrate little understanding of how schools actually operate and end up adding to our workload. (Regional low SES secondary school)

The dissatisfaction with mental health services covered both the psychologists provided by the Department of Education and Training through its student support services and the external services such as Headspace and private psychological providers. Some respondents, particularly in rural areas, indicated that they virtually had no support, while others said that the waiting periods for support undermined their usefulness and left the school to their own devices to meet urgent student needs.

The children I referred for MHP [Mental Health Practitioners] are waiting 6 months plus for an appointment with a psychologist or mental health professional outside school. MHP needs to work closely with schools and parents to support children. Schools are often the first to notice a change in the children but after initial referral there is no follow up to guide staff on the best way to support the child and their family. (Metro primary school)

Principals and assistant principals are generally the key contact at the school for liaison with mental health services. Their perspective about the level of access to mental health services was significantly more negative than that of teachers. Only 20.8 per cent of principal class respondents stated that they had timely access to these services. Significant differences emerge when all staff responses to timely access are separated into school SES and location. Low SES schools which have the greatest need for these services exhibit the greatest level of dissatisfaction with access to them. Just 32.3 per cent of staff in low SES schools reported that they had timely access to mental health services compared to 46 per cent in high SES schools. Schools in regional cities and towns and remote areas had a significantly higher level of dissatisfaction with access to services than those in metropolitan Melbourne.

Living in a small regional town our students don't have adequate access to mental health professionals or facilities. Wait times are extremely long for specialist services, and often an hour of travel time or more, each way, away from their home. (Regional low SES primary school)

Student wellbeing is always a central consideration in the minds of teachers. It is integral to the teaching relationship. Stanford professor Linda Darling-Hammond made the link very clear: “We actually learn in a state of positive emotion much more effectively than we can learn in a state of negative emotion. That has huge implications for what we do in schools.” However, the prevalence of young people and children in schools with mental and social health problems, who are often reluctant to seek help with those problems, means that schools need timely access to specialist resources to support students with additional needs. These resources should be in-school (Student Welfare Coordinators, psychologists and qualified counsellors) and external (mental health services). The AEU mental health survey identified a major gap between the level of student needs and the resources schools have, and have access to, to meet those needs when they are required. 

While this article is about student mental health, the AEU survey also asked school staff about their own wellbeing and mental health. The staff results were in line with a number of other recent research studies which found that teaching can be a very stressful occupation which can contribute to significant mental health difficulties for teachers. Ways of relieving teacher stress, often related to unsustainably high workloads, need to be clearly identified and acted upon in consultation with the AEU. As one teacher said: You can’t teach wellbeing if you aren’t feeling it yourself.

The AEU has a comprehensive set of proposals to meet student (and staff) mental health needs identified in its school staff survey. They can be found here

If you need further support with any of the issues raised in this article, a range of resources is available here: https://www.betterhealth.vic.gov.au/health/servicesandsupport/counselling-online-and-phone-support-for-mental-illness

 

Notes

  1. Mission Australia/Black Dog Institute (2017), Youth mental health report: Youth survey 2012-16, p.29 «
  2. Ibid pp16-17 «
  3. Ibid p.5 «
  4. Carlisle, E., Fildes, J., Hall, S., Hicking, V., Perrens, B., and Plummer, J. (2018). Youth Survey Report 2018. Mission Australia. p.30 https://www.missionaustralia.com.au/publications/youth-survey/823-mission-australia-youth-survey-report-2018 «
  5. Department of Health and Human Services (2015), 10-year mental health plan technical paper, Victorian Government, pp1-2 «
  6. David Lawrence, Sarah Johnson, Jennifer Hafekost, Katrina Boterhoven de Haan, Michael Sawyer, John Ainley and Stephen Zubrick (2015), The Mental Health of Children and Adolescents, Commonwealth of Australia, p.37 «
  7. Ibid p.2 «
  8. Henrietta Cook (2018), Labor plan for mental health in state schools, The Age, October 25, p.3 «
  9. Nicky Duffer, John Polesel, Suzanne Rice (2012), The Impacts of High Stakes Testing on Schools, Students and their Families: An Educator's Perspective, Whitlam Institute «
  10. Tracy Bowden (2017), Year 12 exams — are they worth the stress? 7.30 ABC, 11 October «
  11. Rachel Wells (2019), Stressful VCE could be making depression, anxiety worse among kids: psychologist, The Age, May 7. «

 

John Graham is editor of Professional Voice and works as a research officer at the Australian Education Union (Vic). He has been a secondary teacher, worked on national and state-based education programs and in the policy division of the Victorian Education Department. He has carried out research in a wide range of areas related to education and training. He has had particular responsibility for the many issues impacting on teachers and teaching as a profession, teacher education, curriculum change, and the politics, organisation and funding of public education. He has written extensively in various publications about all of these matters.

This article appears in Professional Voice 13.1 Mental health, reporting and education futures.