Healthy Mind, Healthy Body

By the year 2002 the World Health Organization predicts depression will be the most common and disabling illness throughout the world, with early onset occurring primarily in adolescence and early adulthood. Mental health directly influences children's ability to participate in and benefit from education. Unresolved mental health problems lead to learning problems, decreased academic performance, and more truancy, dropout, and special education referrals. School policy makers and practitioners recognize that social and emotional health problems must be addressed in order for students to learn and perform effectively.

A recent Health Canada report on Mental Health suggests that dispelling myths surrounding mental illness requires community education programs, including school programs that aim to expose and familiarize students with mental health and mental illness terminology and understanding in the early learning years where there exists opportunities for multiple “teachable moments”.

The Standing Senate Committee on Social Affairs, Science and Technology “OUT OF THE SHADOWS AT LAST”, recommends that

• Teachers be trained so that they can be involved in the early identification of mental illness.
• Teachers be given the time and the practical resources and supports necessary to take on this new role.

The Mental Health Commission of Canada recommends that mental health promotion and prevention initiatives must engage communities. It is my opinion that by exposing school children to mental health concepts, repeatedly through the younger years, children and teachers will perceive mental health as part of general well-being similar to physical health. Children and later adults would then recognize warning signs of potential problems pertaining to feelings and behaviours. Such programs can improve the possibility of early detection and recognition of problems by reducing stigma and encouraging early help-seeking behavior.

The program; Healthy Mind, Healthy Body

Healthy Minds, Healthy Bodies is a curriculum supplement designed for classroom delivery in order to fill a recognized gap that currently exists in mental health materials intended for public dissemination. The long term goal of the program is to reduce stigma associated with mental health and illness.

The education program was first pilot tested in a Francophone community in Nova Scotia, in 2001-2002 to ensure that teaching mental health in our schools by school teachers was feasible. Its feasibility was evaluated with support from Health Canada, and the Department of Health. Grass root community representation namely adolescents, parents, teachers, “Conseil Scolaire Acadien Provincial”, Federation des Acadiens de la Nouvelle-Ecosse (FAN), Canadian Mental Health Association, Medical Society of Nova Scotia, Department of Education and Department of Health were brought together to form a steering committee which would inform important aspects of the program in the development and implementation phase, such as ensuring age appropriate materials for teachers and student.

Data from both pre and post delivery evaluation of the 2000-2002 pilot of Healthy Mind.Healthy Body demonstrates that it successfully met intended outcomes. Students showed a statistically significant increase of knowledge about, and awareness of, mental health issues and a corollary increase in displayed positive, proactive help-seeking strategies. (Bianca A Lauria-Horner et al. 2004 The Feasibility of a Mental Health Curriculum in Elementary School, Can J Psychiatry; 49(3), 208-211).

Subsequently in collaboration with Nova Scotia Department of Education Anglophone and Francophone divisions resources have been refined to specifically meet the needs of the Education Institution. English program and Francophone program services have collaborated and provided full support in incorporating Healthy Mind.Healthy Body in the Departments’ objectives over the next 5 years. The new supplements are now an approved resource for all Nova Scotia Schools. In addition, the Department of Education has facilitated multiple presentations to various key stakeholders in order to increase awareness and uptake of the resources.

Healthy Mind Healthy Body consists of 3 supplements. Each supplement consists of the following teaching scope

Healthy Mind. Healthy Body - Supplement One

My Health and My Brain: Grade Primary to Grade 3

The following topics will be introduced gradually across the grades:

• Influences put upon us and influences we put upon others.
• the concept of health consisting of a healthy mind and a healthy body.
• the concept of mental health consisting of the health of feelings, thoughts and behaviors and how this is linked to the brain.
• healthy emotional and behavioral expression – here, students will learn how to define and express specific feelings; learning that feelings are healthy, even if at times one doesn’t feel so good.
• the concept of trust.
• the concept of positive and negative stress.
• problem solving and conflict resolution – here, students will acquire basic skills to describe their problems and conflicts, and learn appropriate steps to resolve a problem or conflict in a constructive manner.

Healthy Mind. Healthy Body - Supplement Two

Did You Know Daddy, I Feel Sad Sometimes: Grade 4 to Grade 6

The following topics will be introduced gradually across the grades:

• Identifying expected feelings and behaviors – Here, students will continue to enhance their learning about feelings, thoughts and behaviors.
• the concept of stress versus anxiety.
• warning symptoms and signs that could indicate a deeper problem namely for major depressive disorder, anxiety disorders and attention deficit disorder/attention deficit hyperactive disorder will be introduced.
• students will also learn that it is O.K. to talk to a trusted adult about their feelings, behaviors and concerns.
• positive development and social skills.
• problem-solving and conflict-resolution – here, students will acquire more in depth skills to describe their problems and conflicts, and learn appropriate steps to resolve a problem or conflict in a constructive manner.

Healthy Mind. Healthy Body - Supplement Three

I’m In Control: Grade 7 to Grade 9

The following topics will be introduced gradually across the grades:

• Identifying feelings and behaviors – here, students will continue to enhance their  learning about feelings and behaviors, as well as the warning symptoms and signs that could indicate a deeper problem.
• common mental illnesses – here, students will continue to learn more in depth about symptoms and signs of the common mental disorders of childhood –  namely major depressive disorder, dysthymia, anxiety disorders, and attention deficit disorder/attention deficit hyperactive disorder -- according to a simplified, age-appropriate, modified version of the Diagnostic and Statistical Manual, fourth edition criteria (DSM-IV). (the DSM-IV criteria are the internationally accepted reference manual professionals use to diagnose these common mental disorders.)
• the importance of early recognition and treatment, and the consequences of delayed treatment
• the concept of stigma attached to mental illness.

The Content for each grade is structured in the following fashion:

Teacher’s Summary

This section contains helpful background information to clarify why the material in this section is relevant for teaching at this stage of a child’s learning development. The information contained in this section is meant to give teachers a fuller understanding of the supplement as it pertains to mental health and it should not be taught to students, as it could be too advanced for the grade level.

Activity Objectives and Curriculum Outcome Link

These objectives are specific to each grade level and are tied into the Department of Education’s health curriculum learning outcomes. Teachers do not have to take on additional workload if they choose to teach mental health.

Method (Teaching Content)

This section contains the topics to be taught to students. This material has been developed to provide teachers with a step by step guidance on how to deliver the topic and to engage students’ interest by involving them in the learning process.

Activities and Fact Sheets

Several, interactive activities have been provided in each section to ensure variety and choice. This material should enhance the topics by adding visual stimulation.

Conclusion

In conclusion, a public health approach to mental health promotion cannot comprise only of treatment, efforts. We need to include factors that promote mental health and reduce stigma. Although there are many diverse efforts and programs required to accomplish this, it is felt that that an elementary and junior high school educational component on mental health and illness would certainly have an impact.

The Long term goal would be to incorporate the program in elementary and junior high schools across Canada

references

1. Health Canada, “Mental Illnesses in Canada—An Overview,” A Report on Mental Illnesses in Canada, www.phac-aspc.gc.ca/publicat/miic-mmac/ (28 July 2006).
   
2. The Honourable Michael J. L. Kirby, Chair, OUT OF THE SHADOWS AT LAST Transforming Mental Health, Mental Illness and Addiction Services in Canada, The Standing Senate Committee on Social Affairs, Science and Technology, May 2006
   
3. Christopher J. L. Murray and Alan D. Lopez, “Alternative Projections of Mortality and Disability by Cause 1990–2020: Global Burden of Disease study,” Lancet 349, no. 9064 (1997): 1498–1504.
   
4. Saskatchewan Education, “Chapter 3: Let's Talk Things Over ... A Sample Unit on Conflict Resolution, ”Health Education: A Curriculum Guide for the Elementary Level (Chapters 1–5 (26 February 2006).
   
5. Carnegie Corporation of New York, “Promoting the Health of Adolescents,” Great Transitions: Preparing Adolescents for a New Century, Reports of the Carnegie Council on Adolescent Development, (22 July 2005).
   
6. Richard F. Catalano, M. Lisa Berglund, Jeanne A. M. Ryan, Heather S. Lonczak, and J. David Hawkins, Positive Youth Development in the United States: Research Findings on Evaluations of Positive Youth Development Programs (U.S. Department of Health and Human Services), (25 July 2006).
   
7. Consortium on the School-Based Promotion of Social Competence, “The School-based Promotion of Social Competence: Theory, Research, Practice, and Policy,” Stress, Risk, and Resilience in Children and Adolescents: Processes, Mechanisms, and Interaction, ed. Robert J. Haggerty, Lonnie R. Sherrod, Norman Garmezy, and Michael Rutter (New York: Cambridge University Press, 1994).
   
8. Martin E. P. Seligman and Mihaly Csikszentmihalyi, “Positive Psychology: An Introduction,” American Psychologist 55, no. 1 (2000): 5–14.
   
9. American Psychological Association, School-Based Interventions with Successful Academic Outcomes, 2003, (26 February 2006).
   
10. Bianca A Lauria-Horner et al. 2004 The Feasibility of a Mental Health Curriculum in Elementary School, Can J Psychiatry; 49(3), 208-211.

. . .