Hope and the Silver Bullet

Are you sitting comfortably? Then I’ll begin.

Once upon a time, long long ago and in a land far away there was a little girl called Hope. In the town where she lived everyone was worried. A monster had been troubling them for some time, but now it was looming larger in all of their lives. Some people had seen it and could describe what it looked like – although it was hard to get an exact picture because it seemed to be a little different depending who you spoke to. Some people had heard it and could describe how it sounded – although it was hard to get an exact idea because it sounded a little different to everyone you spoke to. Some people had felt it brush up against them, and others had sensed it looming large in the background, it’s breath on their neck. Hope would worry day and night about the monster – wondering when it might be her turn to come across it. She would look out for it walking home from school and she would try to spot it from her bedroom window before she went to bed. She would ask her mum and dad every day when it might come, and what might happen if it did. They could offer no reassurances because, quite frankly, they were worried too.

One morning Hope woke up very early determined to find someone who might help. She had heard about a silver bullet – a magic answer to end scary things once and for all and so she set out on a mission to find it. Her first stop was a wise woman who lived down by the river. She was nervous, but she remembered the saying her grandmother had taught her many years before. “Just a few moments of fear might change the course of history” She wished her granny was still alive, but even so the memory gave her the courage to knock. She waited and waited until eventually she heard foot steps. When the door opened the woman looked a little cross. “I’m sorry to disturb you” Hope said “but I wondered if you might have a plan to catch the monster”. “Well I am very busy” she said “ but yes, I have a plan. In fact I’m working on it right now”. She quickly told Hope what it was before closing the door so he could get back to her thoughts. Hope scribbled the ideas down in her note pad and went on her way. “It’s a good plan” she thought to herself “but I’m not sure it’s the silver bullet.”

Next, she called upon a young boy who lived near the woods. He was known to be good at making things, and sure enough his garden was filled with beautiful wooden carvings of animals and toadstools, and benches and swings. “How clever” Hope thought to herself. “I bet he has a good plan”. It took a while for Hope to find him as he was up a tree, but sure enough he was working on an idea. He didn’t have time to come and tell her, but he threw down a piece of paper with a diagram explaining it all. Hope tried to make sense of it – it looked complicated but it might work, she thought. Although she wasn’t sure it was the silver bullet. She taped it into her notebook anyway. And so Hope went on her way, calling on the Doctor, the Teacher, the Mayor, the Baker, the Farmer and just about everyone else, gathering their ideas together in one place. When her notebook was full she headed to the meadow where it was peaceful so that she could sort through everything she had written and put it in order. The ideas were as different as the people she had met along the way. As she read and re-read through the notes she could feel herself getting more and more tired, her eyes growing heavier and heavier. Eventually she fell into a deep sleep, the soundest she had slept for a long time.

Back in the town Hope’s parents noticed she was not at home. By now it was very late and they were very worried. They raised the alarm, convinced the monster had captured her, and desperately fearing the worst. Everyone in the town gathered round as fear grew for her safety. Without exception they all came out, overcoming their own worries about the monster which would usually keep them at home, safe indoors. It was a cold night and so they lit a fire, and some brought food and drinks whilst others made plans about who would search where. They worked well together late into the night, always making sure they set off in small teams; with plenty of  people back at the base resting, and there to welcome Hope in case she returned.

When Hope eventually awoke it was very dark and she felt very alone. Clutching her notepad under her arm she set off in what she hoped was the direction of the town. Somehow it made her feel a little braver. As she drew nearer she caught what she thought was the flickering light of a fire. Then she heard the reassuring hum of voices in the distance – growing louder as she moved closer. Approaching the gathering she felt a warm feeling inside; and eventually she spotted her parents and ran full pelt towards them. As the crowd realised who it was they let out a huge cheer. Hope felt overwhelmed with relief as did they all. ‘”How ever did you find us all  in the dark?” “Well first I thought I saw something, and then I thought I heard something – but mainly I just felt something – I think I felt your love” she said to the crowd. They turned and smiled at each other, a little amused but mostly touched by her childish innocence. “What’s that?” her father asked, pointing at the note book under arm. “It’s my book about how to catch the monster” she said. Everyone gathered round as she read it out loud by the light of the fire, page by page.

By the the time Hope got to the end everyone was sat on the ground listening intently. A calm had descended and all that could be heard was the crackle of the fire. Eventually the Baker spoke up. “These ideas are so good it would be great if we could all have a copy”. Everyone nodded in agreement. Suddenly the shop keeper shouted that he had a printing press rusting in his shed, someone else had ink and someone had paper, someone could help with diagrams and someone could help with binding. Before long there was a plan to turn Hope’s notes into a proper book that every family in the town could have a copy of. They would start the next day. Everyone joined in and after a lot of hard work the book was finished. Bound in leather it was called “How to Catch the Monster” by Hope and the Townsfolk and it took pride of place in everyone’s home. Just having it there made a difference to how people felt.

After that people set about their business as usual – but they somehow missed the industry of the day before. The Farmer had an idea – now it was out and cleaned up they may as well put the printing press to good use. “Let’s start a newspaper for the town” he suggested. There was immediate agreement, and an army of volunteers to help. As Hope had started this all off in the first place they asked her what the newspaper should be called. “The Silver Bullet” she declared immediately, and everyone agreed. No other name would do. And that is how it started – “The Silver Bullet” delivering weekly news to everyone in the town, and keeping them in touch and up to date with one another. It is still printing to this day. In addition to local news, there are items for sale and adverts for events and gatherings. Hope writes a page for the children – usually with quizes and cartoons and dot to dot puzzles. Of course, there is a section in case anyone has ideas to catch the monster, but people seem a little less preoccupied with this these days. Occasionally there are stories about a sighting or something similar. They never make the headlines though because somehow the story feels smaller once it has been told.

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Dear Toronto

Dear Toronto where do I start?
Thanking this city’s enormous heart
Without exception you have been kind
In these dark days; the rarest find
From the streetcar driver who took his time
To the patient folk who wait in line
Every day I have a smile
At strangers going the extra mile
The friends I’ve made along the way
I am grateful to you every day
When I glanced over and caught your eye
You paused instead of rushing by
That’s all it took to make me brave
Next time a nod and then a wave
And then a chat, and then coffee
In busy lives you made time for me
Sometimes it was just a moment or two
But a connection was there I hope you knew
We could have had more if time allowed
For that feeling this city should be proud
Openness surrounds me everyday
Trust and care is the Toronto way
When I reached out it held my hand
Nothing in return did it demand
It makes a difference to your day
(The sun helps too I have to say)
But even when it was crazy cold
It gave me courage, it made be bold
So I pushed my kids to do more too
and you embraced them the way you do
You helped them be the best they can
The only hope in a parents plan
They’ve met people here from far and wide
Sharing cultures and values with great pride
The goal is simple – to get along
And Toronto’s message is “you belong”
Why do I write this? I hear you ask
Well Britain faces an enormous task
To stand alone and turn its back
Or work together, with all its flak
My take home message is very clear
It works. There is no need to fear.
It’s not perfect, I am not naive
But together is stronger I do believe.

Snapping back to safety–oysters open up when they feel safe–and that is when the pearls of wisdom come to light

I have had this blog on the tip of my tongue for several weeks, but couldn’t quite work out what I wanted to say. As ever, a space to reflect with colleagues has helped to bring clarity; and to find the perfect analogy to bring it to life. It is about the journey of transformation we are embarking on in children’s services and how hard it can be to hold onto the ideas that will bring about a real step change in addressing their mental health and emotional well-being. The energy, enthusiasm and shared commitment to do things differently is not in question. The struggle is pinpointing the key elements that will deliver a paradigm shift; verses changes that are positive and welcome but will essentially result in perpetuating more of the same.

At the core of this struggle, I believe, is vulnerability. The vulnerability of the children we work with; and our own vulnerability in acknowledging the extent of their distress and the limitations we have as individuals to help. The system protects us from this in so many ways – from the evidence base that tells us what approach to use or how many sessions to offer; to the drawing of lines around referral and eligibility criteria; to the carving up of which agency is responsible for what aspect of their lives.  The reality, however, is much more complex – particularly for our children and families who struggle the most. Often there are many layers of difficulties that families are up against; in communities that are equally depleted in both resources and, more concerning, in hope. It would be so much simpler if a referral to one service or another, or a neat intervention would sort the problem.

It is so exciting, therefore, that there is a genuine recognition locally that we all need to be in this together if we are to turn the tanker; and that this will involve new ways of working together and new ways of collaborating with children, their families and carers to find creative solutions to seemingly intractable problems. But this is also unknown territory for us all – and as such makes us more vulnerable to snapping back to familiarity and old ways of working and thinking. Like an oyster we have begun to open up – exposing the pearls of wisdom that come with trust, shared goals and compromise. But the uncharted waters we are entering may make us want to protect ourselves and snap shut.

Forewarned is forearmed and so I will try to highlight some of the threats that risk us closing up. I am sure there are many more as I will have my own blind spots; but it is a start that I hope others will join me in:

  • the threat of old narratives that place blame on one service or organisation or agency or even the children and families themselves. Whether it’s about thresholds or expectations or funding or engagement– these are common loops we have all been on. It is of course, much harder to do if we are in the same room together, but if we hear it creeping in we are snapping back to safety

 

  • the threat of unrealistic expectations about the evidence base. It has a place, of course, and informs our practice. However, the families that we worry most about across services are often the one’s who don’t come to clinic, or attend groups in the first place. We need to have confidence to draw on the evidence base to design and evaluate new and innovative services that draw on shared core values; our extensive knowledge of child development and what children need to thrive; and practice based evidence gained over years of working in the local communities. Most importantly we need to talk to children and families about what helps them most and seek their help in designing services that meet their needs more effectively than those currently in place. We need to evaluate these, of course, but if we insist on only the highest level of evidence before we even start then we are destined to do what we have always done; snapping back to safety

 

  • the language of ‘othering’ is something we need to caution against – whether that be target groups of children or families, or specialist professionals to ‘take this on’. That is not to say that we won’t be thinking about need or drawing on expertise. However transformation for children means helping everyone to be able to ‘hold on’ not ‘refer on’. If we find ourselves thinking too much about access criteria or passing problems on then we are snapping back to safety

 

  • indeed language is critical and using terminology that is straightforward, strengths based and everyday is essential if we are to break down barriers across agencies, and more importantly for children and families. Instead of ‘assessing’ why don’t we meet? Instead of ‘screening’ why don’t we ask? Instead of ‘formulating’ let’s think together? It is scary to relinquish professional boundaries, and we must always rigorously embed our expertise, knowledge and competencies in the work that we do – but how much do we hold onto unnecessarily and at what cost? How many barriers do we unknowingly erect? If we are holding on too tightly to our professional identity then we are snapping back to safety

 

  • finally, and most importantly, is the importance of basic qualities that can and do make all the difference to children and families; and are not the domain of any one profession, agency or institution. Kindness, curiosity, hope and the intention to be helpful will have more impact than any number of sophisticated models, services or interventions. If we all prioritised these basic qualities in every aspect of our work then we would achieve great things. If we minimise their importance and allow other priorities to dominate then we are snapping back to safety.

 

Equally there are many signs that we are in safe waters and can be vulnerable. This takes time, and trust, and building meaningful relationships – mirroring precisely what children need to flourish. I have been in more meetings in the last year than in my whole career where we started with a thorny and seemingly insurmountable issue and by the end had reached a positive, and at times, ground breaking solution. The pearls of wisdom that emerge as a result of these endeavours have been precious indeed; and a real privilege to bear witness to.

Thank you to the Gwent Attachement Team for some invaluable thinking space to formulate these ideas.

Sweet Sixteen

Tasha opened her eyes and looked around. It was beginning to feel more familiar. She had stopped having that ‘where am I’ thought that jolts you when you come too in a strange bed. The rose velvet curtains were slightly open allowing light to gently seep in, dust particles dancing in the glow. She could make out the chest of drawers, the desk piled high with her GCSE revision, the striped duvet fresh and clean and clearly bought to ‘match’ with the room – pink for a girl. She wondered if the foster carers had stipulated the sex to go with the room? Or maybe they had said gay or transgender fine too as we have pink curtains already? She snorted a laugh out loud. No. If she had been a boy they would have gone out and bought new. They were kind and thoughtful and trying very hard to do the right thing.

Tasha pulled on her dressing gown from the back of the door (pink, of course, new for her when she arrived and very fluffy – probably Primark – she kept forgetting to check the label). She went down stairs and could hear that Rob and Sue were already up and busying themselves in the kitchen. On the table were a pile of presents and cards, fresh fruit and orange juice and she could smell croissants warming in the oven. “Happy birthday to you, happy birthday to you, happy birthday dear Tasha, happy birthday to you” they sang in awkward unison. “Thanks! That’s lovely!” Tasha said, and meant it. She really did appreciate how hard they were trying. It was in stark contrast to the birthdays that had come before – images flashed before Tasha’s eyes – she pushed them hurriedly away. Not today. Not now anyway.

“Start with the cards” said Sue excitedly. She would rather not. The cards that weren’t there were like knives stabbing her heart. Nothing from her mother, obviously nothing from her father. Nothing from her gran, nothing from Jayne her previous foster carer – the list in her head went on. There it was though, Aunt Esme’s hand writing all the way from Inverness – always C/O Social Services but it didn’t matter. She never forgot. Tasha had never met her but she was the one constant thread in the family, and she always remembered birthdays. She imagined her living in a brightly painted cottage like on Ballamory, grey hair in a bun, a flowery apron on as she went about her chores, and freshly baked bread cooling on the table. The reality was probably very different – which is partly why Tasha never planned to track her down.

And there they were. The cards from her brothers and sisters. Ricky and Will who were living with Pam and Dave, Tara, Amy and Tillie who were with Rita and Richard, and the babies, Louis and Harrison who had been adopted but still allowed to send birthday cards and would meet up once a year as part of the ‘plan’. They had all been helped with their cards to some extent – but they were all there. For Tasha it was like counting her chicks. Her social worker had sent a card too. And Rob and Sue of course, and Rob’s mum – which was nice. Sue encouraged Tasha to move on to the presents – all wrapped meticulously in the same paper. A couple of books (‘teen lit’ Sue had done her homework), some smellies from Lush, some pyjamas (from Primark – Tasha checked there and then) and a small package Sue was excited about her opening. It was a navy velvet jewelry box and inside was a beautiful gold locket. “Sixteen is a very special birthday Tasha. We wanted you to have something to treasure forever”. Tasha felt tears prick the back of her eyes. Here it came again, they were so kind and generous – how do you say “thank you but how the fuck do I fit seven brothers and sisters in one locket?” Tasha gave Sue and Rob an awkward hug and left them to interpret the tears in whichever way they wanted.

Tasha was the oldest by five years and had been ‘placed’ on her own when the children had first been removed. Back then it was just her and the boys, an ‘awkward’ sibling group to place altogether. The more babies her mum had the easier the groupings became. Three girls close in age. Bang. Bang. Bang. And then twin boys removed at birth. Bingo! Adoption gold dust. Tasha had moved in with Jayne – a single carer who had fostered for many years and was ‘very experienced’. She liked it there, laid back with no pressure and other kids passing through from time to time. Ideally, she would have stayed until she was eighteen, but after 20 years as a foster carer and some sort of award from the queen, Jayne was packing it in and moving to Spain. In some ways, the social worker said, it’s worked out well. Tasha was bright and could make a real future for herself but Jayne had never really been able to help her academically – she was more of a hippy, a free spirit. Moving to Rob and Sue’s and going to Heathwood High for her last year of GCSE’s would be perfect, and really allow her to focus in on her exams. It also meant she wouldn’t be tempted to keep an eye on her brother – who was about to start at her old school. The social worker saw that as a positive. Tasha had been devastated.

It was all bull shit. No one moves school half way through their GCSE’s. It was hilarious (in a not funny kind of way) how they always tried to make the story fit as though it was the plan all along. Jayne moving to Spain had been gutting – there was no way around it. She was ‘retiring’ from her job of ‘caring’ for Tasha and the other foster children who had passed through. Tasha had been ‘well looked after’ by her (well enough in a “there’s a chick pea stew on the hob help yourself if you’re hungry” kind of way) but the ties could be cut. Blood is thicker than water (even if it’s being splattered on your face from a fist fight) and even Aunt Esme who she had never met had sent her a birthday card. She tried not to take it personally with Jayne. Hippies didn’t do birthdays very well. But they did do open doors and Tasha knew deep down that if she pitched up in Spain, at any point in her life, Jayne would welcome her in and she could help herself to some veggie paella from the hob. That counted for something.

Anyway, ironically, it was working out ok. And Tasha really did want to do well at school even if her primary aim was to earn enough to take care of her brothers and sisters when the time came. The first day had been foul. For any kid starting at a new school it’s horrific. When you are a foster kid, starting half way through GCSE’s in a school where everyone knows each other and has done for years, it’s in the ‘blank off all feelings, out of body experience’ category of foul. The groupings are set, the in crowd know who they are, the geeks know who they are, the sporty kids know who they are, and the bitches smell the blood of new prey before they have even checked out what shoes you are wearing. But somehow Tasha got lucky. She ended up in the form full of waifs and strays with no clear identity other than they always lost in competitions and took great pride in it. They united in being the losers and weirdos and even made a thing of it. She was sat next to Abigail – confident, kind, and pretty in a not a scrap of make-up kind of way. They instantly bonded over a Fall Out Boy pin on Abigail’s ruck sack. One of many ranging from Harry Potter to a Gay Pride rainbow. Abigail didn’t hedge her bets – she liked what she liked and couldn’t care less what anyone thought. She also had lots of friends in the form – simply because she was nice. Tasha realised she would be just one of many and never the ‘best friend’ – but that was way better than she could have hoped for in the hell hole that is friendship groups in comp.

Best of all, Abigail’s birthday was the same week as Tasha’s. “Let’s have a joint sweet 16” she had declared. Tasha felt the panic rise – that sounded horrific. “Not in a fake tan short skirt tattooed eyebrows kind of way” Abi rushed to clarify. Phew, thought Tasha. “In a bake lots of sweet things to eat kind of way”. She loved how Abi could turn things around, and make what everyone aspires to, the ultimate selfie at a drunken party, sound boring and mainstream compared with the alternative idea. “We will do it at my house, bake all day. We can take the left overs into school.” Fun, inclusive, and most importantly safe. How did Abi manage it? “It will need to be on the Sunday – which is your actual day – is that ok?” “It’s fine” Tasha said. She was relieved she would be doing something and not having to choose a restaurant and a film to go to with Rob and Sue. She could do that on the Saturday, and meeting with her brothers and sisters at the contact centre in case her mother showed up would be on a week day anyway. Sue was a bit stung when she told her, but also relieved that the whole responsibility for her birthday didn’t fall to her. Rob was genuinely pleased for her, grasping at any straw that Tasha was settled and happy.

Abi’s house was just like her – not trying too hard to be anything, but confidently stylish as a result. She had laid out recipe books and ingredients and mixing bowls in readiness. Her mum checked they were ok and then left them to it. “I’ll be in the front room if you need me” she said. They poured through the books settling on millionaire short bread for the complicated thing, chocolate chip cookies for the easy thing, and a Victoria sandwich for the centre piece. “We don’t need a recipe for that I know it off by heart”. Abi said “I’ve made hundreds with my mum from when I was really little.” They worked together, the mess mounting as the delicious smell of sugar and butter baking permeated the house. Eventually they were finished – their achievements proudly displayed on china plates and cake stands – it looked amazing. They took photographs and Abi posted one on Instagram with a simple “Sweet 16” and tagging them both. Abi’s mum came to see. “Wow that is fantastic girls!” She declared. Tasha felt so proud but also a bit sad – it was only that good because Abi knew what she was doing; and she only knew what she was doing because her mum had taught her. There it was again, that gaping hole.

They tried a piece of everything they had made with a cup of tea before sharing it out into cake tins ready to bring to school the next day. Tasha saved some sponge for Rob and Sue. It really was delicious; and Sue declared it the best Victoria Sandwich she had ever tasted. “Abi knows the recipe off by heart and didn’t even set the timer on the oven – just kept an eye on it through the glass” Tasha told Sue, sharing some pride in her friend’s skill. “Wow that is impressive; but it just takes practice” Sue said. “I can teach you if you like. Shall we have a go next Sunday?” Tasha nodded, feeling that familiar prick of tears behind her eyes.

Children with mental health difficulties are falling through the cracks–we need many safety nets of varying shapes and sizes if we are to catch them all

There is nothing controversial in the reflection that children’s mental health services are at crisis point. The controversy comes when we try to agree the ‘solution’; with a huge variety of ideas vying for attention in a very crowded ‘market place’. Every service and profession will justifiably argue that they need more resources; and of course more resources would help. A bit. However, I would argue that the scale of the problem is so enormous that investing in pre-existing models will not provide ‘the answer’. Indeed, more concerning, this approach may even perpetuate the problem; especially if we invest in ‘specialist services’ that carve off mental health difficulties from every day life. We need a ‘whole school’, ‘systems wide’ approach, with a range of safety nets if we are to be sure that children don’t fall through the cracks.

I will use the ‘net’ analogy to illustrate the point. Currently Specialist Child and Adolescent Mental Health Services (SCAMHS) could be described, for the most part, as a basket ball net, and one that is located far outside of the schools and communities where children live their lives. Teachers and other child care professionals have to put a huge effort in if they stand any chance of ‘scoring’ help for a particular young person. Often it’s a miss – either because the person doesn’t meet the tight referral criteria, or because they don’t fit neatly with the help that is on offer at a specific moment in time. Miss your chance and it’s gone. Indeed, the basket ball net maps very neatly with the way in which SCAMHS works. Children and young people pass through, and rarely does the service stay involved for an extended period. There is huge pressure from within specialist services to ‘let go’, essential if capacity and demand models (for example the Choice and Partnership Approach), and target waiting times are to be achieved. This is not a criticism. It is inappropriate for ‘specialists’ to remain in a child’s life for prolonged periods of time, especially when there is not active intervention focused on change, and it is not helpful for specialists to drift into more supportive roles. Far better that this support is facilitated through the every day relationships in a child’s life. However, it is no doubt a huge source of frustration for all concerned when the ‘specialists’ withdraw, especially when there are not other support systems in place to ‘catch’ the young people at the other end. Mental health ebbs and flows in all of ours lives, and is rarely, if ever, ‘cured’ once and for all.

In recognition of this frustration, there have been calls for more specialists to work within schools and other community settings. It certainly would address the perceived distance and inaccessibility of the current system, and I appreciate that it is very appealing for overstretched teachers and child care professionals. However, my concern, especially if this is seen as THE solution, is the risk that it replicates one of the biggest disadvantages of the ‘specialist’ services model.  By this I mean perpetuating the commonly held notion that mental health can somehow be seperated off, and is the business of only those with ‘special’ training. If it were a net I would argue that this is a fishing net approach –  a specialist on site scooping up the children and young people who present in a certain way that rings alarm bells. Again, ‘referral criteria’ would be required, and some would fit, whilst others, often our most vulnerable who act out their distress behaviourally, or who don’t show up to school, would not. It would also, inevitably, be dominated by a ‘within child’ model of therapeutic support (e.g. counselling, CBT), failing to recognise the hugely important contextual factors that impact on a child’s mental health, including poverty, adversity and ongoing exposure to trauma. I have written about this risk in a number of my blog posts. Far better that those specialists share their fishing knowledge, and hand out smaller nets to core staff, supporting them from the sidelines – empowering and up-skilling them all the while.

However, the net I would like to see if we are truly to turn children’s mental health concerns around, is the safety net. A ‘catch all’ whole system approach, where we apply what we know helps children to flourish to all our children in all our child care institutions. A set of values that nurture and celebrate our young people should be at the heart of all child care practice. This would focus on relationships, and facilitate safety, connection, warmth, celebration of the unique individual, inclusion, and a recognition that not all children are starting from the same baseline – whether that is developmentally, temperamentally, emotionally or socially. Again, I have written extensively about this and how it might work in practice. The beauty of it is that simple changes can make all the difference; often requiring no additional time but rather a redirection of focus. Most importantly, the outcome of children flourishing means the academic targets so prized in our culture would follow. Indeed, it could be argued that even our brightest, most secure and privileged children survive rather than thrive in the current system. With this approach they would continue to shine, and those who get lost in the pressure to achieve,or in the chaos of their disruptive home lives would also find their place. Children cannot learn if they don’t feel valued and safe.

So, in summary, we need to think more creatively about the nets to catch our children to prevent them falling through the cracks. Specialist CAMHS has it’s place, as does more accessible and targeted support. However, if we are to really tackle the enormous problems with mental health we are facing as a society, both for our children and the adults of the future, then we need a safety net for all. A whole systems approach that embeds emotional well-being and mental health in every aspect of our children’s, and those who work with them’s lives. Where schools become a place of safety and security for our most vulnerable young people; where inclusion for all becomes a focus, and a celebration of the uniqueness of the individual becomes the norm. It is not that ambitious, and as I have written about recently, just changing the first five minutes of the school day can make a huge difference. The price of not doing this is, on the other hand, is enormous, and we know from the Adverse Childhood Experiences research that the impact of not taking serious action is alarming not only for mental health but for physical health too. To put it bluntly, it is like asking a trapeze artist to perform with only a basket ball net to catch them if they fall. Instead, we need to empower everyone in a child’s life to recognise that if we all hold on to the safety net no one need fall through. Indeed, these everyday relationships with those most proximal to the young person have the most therapeutic power. With this in place as our baseline, the children and young people who need to be fished out for specialist help would become obvious – always keeping in mind that they are coming back and will need to be held by us all.

The first five minutes of a child’s school day……..

There is nothing like a cross sector workshop dedicated to a ‘whole school approach’ to get people talking about what we could and should be doing differently if we are to achieve a step change in children’s mental health. And bravo to Wales for starting the conversation. Like any good debate it veers from one extreme to the other. On the one hand there are calls for more counselling in schools, and quick and easy access to specialist help; right the way through to radically rethinking every aspect of how we nurture and educate our children. The consensus, though, is clear – something needs to change. It’s the what and how that is the trickier bit.  It can feel a bit  like a balancing act – all suggestions have validity but too much of one thing risks it all tipping over. No one would argue that more experts with specialist training wouldn’t help, but the more we carve up mental health to someone else the more trouble we are storing up for the future. The culture of ‘referring on’ is a fundamental issue to shift, with ‘holding on’ being a far more transformational aspiration. However, too much pressure on schools to provide the whole answer and they understandably end up feeling paralysed. Especially given the current stress teachers find themselves under. We all have to be in this together if we are to achieve the change we need to see – with a whole school approach just one element of a ‘systems wide paradigm shift’. As if we didn’t already think we had enough on our plates.

I wanted to respond to offer my reflections on how we find the middle ground without compromising our vision. I believe it is possible for us to both THINK BIG and START NOW. It all centres around the core values that we focus in on;  and we can use the current frameworks to start the process of cultural change by enacting these values at any and every opportunity. Let’s take as an example the first five minutes of the school day. What message does it give our children? What message does it give every single one of our children?  My own children went to a great primary – one of the ‘best’ if you judge a school by league tables, and how much the places, even within catchment, are oversubscribed. At the time I didn’t think too much about it, but in hindsight the first five minutes of their day said a huge amount about the school, and it’s values.  The much respected headteacher would stand at the gate, late book in hand. She would smile and say hello but the message was clear – you had skidded in just in time. Others behind you would not be so lucky. The children would gather in the yard and when the bell rang they would line up by their door – girls in one row, boys in the other. No-one would be let in until everyone was standing still. A familiar routine, I’m sure, that takes place every day of every term up and down the country.

None of it was particularly controversial, and I don’t remember feeling too perturbed by it at the time. We take much of the education system for granted and don’t think to question the minute by minute minutia. However, with the benefit of hindsight, and viewing everything through the lens of children’s mental health, even within this tiny window in a thriving school I can now see cracks for children to fall through. Being on time is, of course, something to aspire to and a valuable life skill. It is easy to achieve if you are a child in a family that values this too, and has the resources (physical and emotional) to make this happen. But what does being shamed by the late book mean for the child who has had to wake their parent and dress their little sister or brother before the school day has even started? Boys and girls lining up by the door is a very straight forward and seemingly benign request. But what does it say to the child who was born into a boy’s body when they feel like a girl inside? Every single day? Standing still is never easy for children, but for some children it is a near impossible task. What does it say when you are always ‘that child’ who delays your class from moving onto the next activity?

If we choose to look at these first five minutes through the lens of a values base that underpins positive mental health then how might it look? For me, and echoed by many of my colleagues in the workshop, the values would centre around creating a culture of  safety and belonging, of connection, of empathy, of celebrating individuality, and of fun – to name but a few; and all achieved through warm and supportive relationships. With these values informing everything that happens in a school how might the first five minutes of every morning be different? Well, very simply, the headteacher would greet every child with a smile, and a “welcome to school, I’m really pleased you’re here”. They might notice who is late, but instead of it being a black mark it would become a cause for concern and a prompt to be curious about what might be happening at home – especially if there was a pattern. The children could then line up in which ever line they wanted – so long as there were two relatively even ones. Maybe even when the outdoor clock said the time, or when the teacher arrived at the door rather than a bell ringing – where else in life do we respond to a bell? Maybe instead of standing still the children could do whatever they wanted to on the spot – hop? jump? spin? So long as they were respecting the space of the other children around them why shouldn’t they get some physical exercise in at the same time? It could even be a game of Simon Says? With these values informing what happens in school the children would experience a very different start to the day, every day, and it would take no more time from the teachers involved.

If we wanted to take a step further along the continuum towards a ‘whole school approach’ to children’s mental health how might the first five minutes of the day look?  I had the privilege of experiencing a very concrete example during the three years I spent with my children in Canada. At my daughters school the children went in when the doors opened (like we do in most areas of life). Piped music was played through a sound system throughout the building. The songs were chosen by the older students on a rotation. On my visit it happened to be ‘The Final Countdown’ by Bon Jovi. The children were dancing as they took their coats off, and when I glanced in the class rooms some of the teachers were dancing too. At 9am the music changed to the Canadian National Anthem and all children stood by their desks and sang along. Toronto is one of the most multicultural cities in the world, and yet every child joined in and felt a sense of belonging – even my own fiercely loyal Welsh off spring. When that was finished, one of the teachers would talk through a mindfulness exercise that everyone took part in – it was even piped into the office. The three values communicated in the first five minutes were fun, inclusion and well-being.

And a step further along the continuum towards a ‘whole school approach’? Again I turn to Canada, and to my son’s move to high school, aged 14 – when engagement is hardest and risk of mental health difficulties soar. He went to an Arts school – but there were a number of options he could have chosen from in recognition that all young people are different and have different strengths. For example, he could equally have gone to a robotics school, or a sports school or even a school that focused on social justice. There was also the local high school, of course, for kids who were all rounders or who didn’t feel ready to narrow their options down. The first five minutes of his day involved walking down a corridor with expressive and expansive murals covering the walls and doors, including the gender neutral, male and female toilets. Dancers limbered up in the hall, singers and musicians practiced in rehearsal rooms and visual artists prepped in studios. His major was music and so he would go to his form room and set up his drums each morning, joining the rest of his class of musicians who made up the band. “For the first two lessons we focus on their major”, the head teacher explained, “because we want to get them through the door for something they love. Then it’s our job to engage them in the lessons that may hold less appeal.” All children had a general education too. None of the children in any school wore uniform…..because the fact that children aren’t uniform came across strongly as a value in the education system.

I share these just as examples from my own personal experience of how things could be different. Do I think Canada has found the silver bullet when it comes to children’s mental health? Of course not. There isn’t just one. But it certainly feels closer than we are even by the ‘first five minutes test’ to having a set of values that underpin positive well-being and mental health. I have also heard of several young people in my son’s Art school who say that the school saved their life. A safe space that allowed them to be themselves and celebrated their unique individuality was the thing that made all the difference to their mental health; especially important for those who had struggled to find their place in a more generic, less accepting, school environment.

There are, of course, probably many more steps along the continuum we could take. I would suggest we could even turn it around and ask how would we design schools if we were starting from scratch? We know so much more about children’s emotional well being, what they need to flourish, about child development, attachment, the adolescent brain and about the impact of adversity and trauma. If we used this evidence base as our starting point what would our schools look like, and how would they work?  If we had a blank page what education system would we create? If feels important not to lose sight of the ideal; and it would be an easy and fun question to ask children what the perfect school would be like – or even the first five minutes of the perfect school day. A ‘whole school approach’ means looking for and finding the cracks that children fall through and thinking creatively about how to fill them. There are only so many cracks you can repair before you consider whether a rebuild is a cheaper and safer alternative. Let’s think big, but don’t let thinking big prevent us from starting small. Every step can make a huge difference, especially for an individual child. And the first five minutes is an easy place to start.

 

 

 

 

 

 

 

 

That feeling when you make the team……..and why we are missing a trick by only reserving it for the ‘sporty’ kids

This is my daughter, aged 10, and this is the moment she made the team. She wasn’t going to be playing her first game until a week later; but even so the whole kit had to be tried on there and then, shin pads and all. Her sense of pride is evident; that smile speaks volumes. It was the Spring following our move from the UK to Canada; and the first time in her life she had seen herself as someone who could do sports. Up until that point she had always classed herself as one of the ‘unsporty’ kids, who never got picked. I say always. It followed numerous experiences in school of trying and falling short. It’s a feeling all too familiar to many, her own mother included. Just a quick poll on twitter has indicated that out of over 1300 people who responded, 40% would refer to themselves as ‘not sporty’ at school, rather than seeing themselves as ‘sporty’ (35%) or ‘somewhere in between’ (25%). Given our growing concerns about obesity, alongside how we know physical activity is good for emotional well-being, cognitive development and concentration; that is a huge percentage of children who potentially write themselves off. Those feelings don’t go away, often impacting on our relationship to physical activity throughout our lives.

The soccer league in Toronto was different to anything I had come across in the UK, despite years of searching. I had been determined that, unlike me, my children should have sport in their life. However,  given that it didn’t come easily to them, finding a club or setting that wasn’t highly competitive had been impossible; especially after the age of about 6. This league was huge, with about eighteen teams all randomly allocated. Each team was sponsored by a shop on the high street – hence the Yogurty’s  logo on her shirt. Every Tuesday evening the teams comprising of children from all different schools, would congregate on a large field with 9 soccer pitches marked out, playing each other throughout the season. The teams were made up of mixed abilities; including some children with learning disabilities.

It was local, relaxed and most importantly, fun. Each week my daughter got a really good work out – coming off the pitch hot and sweaty and with a sense of accomplishment that is hard to beat, regardless of the outcome of the game. Sometimes they would win, sometimes they would lose, sometimes she would score, often she would not. The random nature of the teams kept it open. Of course, she would be delighted if they beat the other side, but either way she still had a great time. Over the course of the season, everybody’s game improved. Team members took it in turn to supply half time refreshments – cut-up melon or oranges; and new friends were made by us both. The dog came too, of course.  It helped that we were usually bathed in evening sunshine.

I don’t underestimate the organisation that went into setting up and running that league, and associated leagues on different days, but it seemed to be a shared endeavour. The coaches and assistant coaches were also randomly allocated to their teams, and tended to be parents or local teachers and youth workers. It was very laid back, and encouragement and enthusiasm seemed as important as any technical knowledge of the game, although some solid coaching with a focus on team work was evident. More experienced coaches were paired with less experienced assistants, and many had been doing it for years. The referees tended to be 16 and 17 year olds, all trained and doing it as part of their volunteering for high school. No-one can graduate in Canada without accruing a set number of volunteer hours, and, as such, it is considered as important as the academic aspect of school. What a great way to give back to your community.

The fee for the league was nominal, and the kit was supplied by the high street sponsors. At the start of the season there was a table of boots laid out according to size and you could help yourself if you didn’t have any, or swap a pair each season as your child’s feet grew. The sponsors got a good deal in local advertising – especially Yogurtys, as their team frequented the frozen yogurt joint as part of their social meet ups. The team photo was displayed in pride of place in the shop, and other teams could be spotted in the butchers, the opticians, the fish mongers and just about every other business on the high street.  It really was a community affair; and something most kids seemed to be involved in. On the final Sunday of the season there were play offs, with first, second and third placings, but that really did seem incidental. My daughter played in the soccer league for all three summers we spent in the country. It was hard moving from Yogurty’s as a sponsor, but finding out who you had next and going to see your picture in the shop was all part of the fun.

There were, of course, more competitive leagues too and competition in sport is alive and well in Canada. Indeed, I have read some pretty terrifying articles about the world of kid’s hockey and what it takes to make it to the top. The point is that there is also lots of team sports that aren’t competitive to the same extent, and that pretty much every child has the opportunity to be part of. After a year or so my daughter also took up Ultimate Frisbee in a similar set up, which she really loved. She had tried it at school first, had been encouraged by her teacher, and felt positively enough about it to go along to a club. There were lots of other options including baseball, basketball and hockey, of course. In the winter there were over 50 ice rinks to skate on, all free, and exchanges to swap your skates as you outgrew them each year. In the summer the outdoor pools were free, as was public transport. It all felt easy, accessible and something that was open to everyone.

On our return to the UK my daughter went into year 8 of high school. Very quickly she was ‘streamed’ in PE and put in bottom set. Like a switch I saw her confidence in her sporting abilities disappear over night. When I ask now how PE is going she groans. At the regular cross country race she tells me she walks at the back to keep her friends who also dislike sport company. She is still part of a team, only now it’s the ‘don’t do sport’ team. Fortunately she loves dance, and is part of an intensive class outside of school. She is a great dancer but flexibility is something that she finds tough. She perseveres because she enjoys it, and she loves meeting up with her friends of course. It is not cheap, and many families would simply not be able to afford it. Without dance I am not sure what she would do for physical activity; and it is something that really saddens me – especially as I know it can be so different.

It also makes me think about the role of sport for the more vulnerable children in our communities. Without any doubt for some it is a lifeline, but my guess is they happen to be the ‘sporty’ ones already. Going back to the poll it really does seem to be a clear dividing line here in the UK  – either you are or you aren’t sporty with only 25% seeing themselves as somewhere in the middle. It doesn’t have to be that way, and if we want to tackle major issues facing our society like obesity, isolation, screen addiction as well as providing lifelines for our most vulnerable young people then we need to take action. The pay offs for children, their futures, ourselves, our communities and even our high streets is worth it.

My starter for ten would be to start in school by not grading sport; and certainly not streaming kids into sets. Instead I would ask them do they want to do fitness for fun or for competition, and group them accordingly. They could always swap if they changed their mind, or showed real potential that needed to be nurtured. If the purpose of the lesson became enjoyment with fitness as a by product what a gift for the rest of their lives that would be.

Today’s run…….how Facebook got me outside, active, connecting with nature and making real friends

I’m as troubled about social media and the impact on mental health as anyone. Of course I am – I’m a parent of teenagers; and a psychologist who witnesses the consequences of the worst of it on a regular basis. From cyber bullying, to feeling excluded, to withdrawal from social interaction, to an obsession with image these are very real concerns impacting the daily lives of young people. No one is immune and I worry about my own reliance on my phone; and the way my anxiety can rise when the battery is about to die and I have no way of recharging it. Most of all I worry about babies and young children – desperate to make eye contact with the adults around them who are engrossed in their screens. I am concerned that the impact of this, and what it means for their developing brains and social relationships, will become the biggest public health issue to face the next generation.

The irony that I am writing this on a computer and will be posting it on twitter is not lost on me. However, there is definitely a plus side to social media; and the fact that I can share these reflections with many thousands of people across the globe is just one. Indeed. I have been blown away by my newly found twitter community and how this has enabled my blogs about children’s mental health to be read and shared by so many. The connections I have made with like minded folk around the world has been inspirational; and I have learnt so much as a result. I therefore wanted to take the opportunity to write about a very positive side of social media that really helped my own mental health at a time when I needed it most.

We had just moved to Canada, and after the busyness that comes from such an enormous relocation had settled; and my kids were in school and my husband was at work, I found myself completely alone in a strange and frozen land. The children were distraught at having to move, and my husband was stressed in his new and daunting role. It was a very unhappy time for our family and I was at risk of spiralling into a pit of loneliness, sadness and regret. I knew I had to take action. I decided I would restart my running – something that had a taken a back seat in recent months what with all the stress of giving up work, packing up a house and dragging two children kicking and screaming half way across the world. It had been something I had discovered late in life, having been a determined member of the ‘can’t run, won’t club’ since I was a child.

I knew I always felt better after a run no matter how much I dreaded going. Usually I had someone to run with to ‘force’ me to go. Here I had no one. I decided to call on Facebook to help me out. On a freezing (I mean –15, seriously freezing) Monday morning I posted my declaration. “I need your support Facebook. Please help me to get out there running again. I am going to post a picture every time I go”. I had already done my first one so I uploaded the photograph. After that I posted a picture of every run I did for a whole year. On reflection, the impact that had on my life, and the first 12 months of my time in Canada was profound. Looking back the advantages align really well with  Five Ways to Wellbeing and so I will use that as a framework to share my journey. I should say our journey. The dog always came too.

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Be Active

The most obvious positive gain from my runs was the physical activity. Don’t get me wrong, I never ran far or for long, especially at the start, but I counted things like getting dressed, going outside, having fresh air, raising my heart rate, giving the dog exercise all as benefits to this process. Especially when the alternative, doing nothing, was so very tempting. The fact that it was freezing meant it took a huge effort to persuade myself to go, and without the incentive of posting it on line, and the public commitment I had made, I am certain I wouldn’t have bothered on many occasions (if ever). Just through sheer habit my fitness increased, and from the January to the May I was ready to run, albeit very slowly, the first of several half marathon’s in Toronto. The further I ran the more I discovered about the city I came to love. It was a pivotal moment when I realised how close we lived to the shores of Lake Ontario. I was at a very low ebb at the time  but it helped me to look forward to the warmer months and having this beautiful sight on our doorstep. I also ran whatever the weather – and Toronto can be very extreme. This photo of me is during a snow storm, at a temperature of –20. I wasn’t out for long!

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Take Notice

This is perhaps one of the most powerful differences to running that the posting of photographs made. I never listen to music, instead disappearing into my head and processing all sorts of ‘stuff’, positive and negative, when I run. Having to take notice, and actively looking for something to take a picture of helped me to spot all sorts of interesting things I would otherwise have passed by. I also had to look for something new and different every day, despite frequently running the same routes. It became the focus of the run to see what I might spot. Everything from the wildlife unique to North America, to the sublte signs of a soft and gentle culture were there to see if I looked closely enough. Things I am certain I would have otherwise missed.

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The runs also helped me to take real notice of the changing seasons. Extreme in Canada, and marked dramatically in the way people decorate their homes as well as by nature. Spring was the hardest time for me as there is no sign of it anywhere. The city went from a frozen landscape at the end of April to a balmy summer heat at the beginning of May. Seeing all the Welsh daffodils in March back at home was so hard, but when the warm weather eventually arrived, and the famous cherry blossom burst into High Park, I was overjoyed.

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Connect

Without doubt the most profound impact of my runs was the life long friends I made. At first my connections were virtual, and I don’t underestimate the power of friends at home supporting me when I needed it the most. It was those connections that kickstarted the whole journey. However, my running also connected me with friends in the real world too. From nodding and smiling at people in the local community on a regular basis to conversations in the dog park about having seen me and my very noticable labradoodle out and about, to sharing my story about posting my runs everyday, friendships started to be made. One day, at the dog meet (a regular gathering of dogs and their owners) I was chatting to a new acquaintance and she said she would come too as she was trying to get back into running herself. That was it, the start of a beautiful phase of running everyday with a new friend. We look back on it as our golden time as the weather had just turned warm and she was between jobs (she worked in the film industry) and so we were able to run every day. It was a turning point for me – I had made my first friend in Canada. And of course, the dog had his first friend too. Suddenly there were photos of me taken by someone else, and of trips to cafes for a treat after our endeavours. I had someone to share the joys of the changing seasons with, and the prospect of another winter was no longer terrifying.

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Keep learning

Maybe learning is not the right word, but my running certainly kept me discovering.  I would try new routes as often as I could, finding new neighbourhoods and parks and ravines I would never have known existed. Whenever we travelled, whether it was within Canada or to new places I would keep my running posts going. It is a brilliant way to take in new places quickly, and often at less busy times. The cover photo is a frozen Niagara Falls taken early in the morning without a soul in sight. The boat is in Iceland, a quick run fitted in on a 24 hour stop over on our way back home for a visit.

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Giving

A less obvious way that my runs contributed to well being is throuh giving, and mostly people gave to me with their online support and encouragement. I gave to myself, too. Allowing myself the time and permission to do this, and forgiving myself if a run was very short, or if I didn’t go on a particular day. Facebook friends told me they loved my posts and that it encouraged them to get out there and go for a run. Many even posted photos which I loved to see. When my friend had to go back to work I would sometimes get up at 5.30 in the morning to join her on a run so that she could keep the momentum going, and she appreciated that enormously. That’s us before the sun has risen – catching the best of the day together. Some of our most magical runs were in the silence of the city before the dawn broke – especially after a fresh blanket of snow had fallen.

After my year was up, and I was no longer posting pictures, a new friend came along. She had just moved to Canada from the UK herself and was experiencing all the angst that I had been through. I asked if she would like to take up running. She was reluctant, and anxious having never run in her life, but prepared to give it a go. We started very slowly, and went every day. Before long she was loving it. The last picture is us completing her first ever 10k race – a profound moment for her; and one I will treasure forever.

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