Health Promotion of Mental Health Programs in Schools

Mental health programs for young people can only be successful if it is flexible, culturally appropriate and more specifically centered on their needs and concerns. (Vranda, M.N., 2015). The ideal place for such programs is the school where there is ample opportunity to promote the mental health of young people. Stress, anxiety, and depression are the most frequently identified mental health problems among students. Psychoses, substance abuse disorders and self-harm tendencies, which are less common and are poorly addressed, but often much more serious and enduring (Roy 2019). Many of the mental, behavioral and psychological problems among children and adolescents can be prevented, if it is diagnosed and intervened at an early stage. School-based interventions possess great potential in reducing the risk factors and increasing the protective factors to promote the mental health and well-being of children and adolescents. A well-inclusive program has the potential to build efficiency among children and adolescents in schools if it incorporates teachers as facilitators and this yields long-term outcomes on investment. Good mental health is vital to children and adolescents’ success in school and social life. Researches confirmed that students who receive social-emotional and mental support always achieve better academically. It also improves the perception of healthy a School climate, classroom behavior, on-task learning, and students’ sense of connectedness and well-being as well (Thapa, Cohen, Guffey, & Alessandra, 2013). So, schools must recognize and respond to the diverse mental health and well being needs of students and thereby ensuring quality education to all through the appropriate curriculum, organizational arrangements, teaching strategies, and resource supports.

In this context, schools have a unique opportunity to improve the lives of students. Progressively, schools should expand their role in providing services for the overall child and adolescent development and well-being. As a powerful socialization agent, the school plays an important role in the transformation of cognitive, linguistic and psychosocial competencies. School is not just a place of educational learning, but also an important environment where children make friends, develop social networks and are introduced to adult role models. The school setting, being a place of learning and modeling, has the potential to contribute positively to students’ mental health and well-being. It is important to build happy, healthy and harmonious schools for students' mental health welfare, which are significant demographic dividends and most important national assets. It is to be noted that India does not yet have a comprehensive approach and practices for school mental health promotion.

Existing policies and services for Mental Health Promotion in Schools: In India, there is no separate all-encompassing policy to deal with mental health issues in schools. Children's mental health policy is limited, and the behavioral and emotional support needs and aspects of special students are completely ignored. In the five-year plans, the government has earmarked only a few crore rupees for the mental health of the entire country, in which mental health promotion of the child has received very little priority (Bhat, 2012). Many mental health or other disabilities programs and policies have lots of complications related to its nature, administration, or access to a targeted group of people. In a report by WHO (2011), mental health facilities are limited in India. And primary health care doctors and nurses have no official in-service training in the mental health sector. Mental health expenditure by the Indian government is less than 0.06% of the total health budget (Mishra & Galhotra, 2018). The existing policies such as the National Health Policy, Integrated Child Development Scheme and National Mental Health Program, etc. stress the need to be more comprehensive at various levels. India has adopted several national policies in different areas of child development, which include the National Policy for Children (1974), National Policy for education (1986), Mental Health Act (1987), Charter for Children (2004), National Mental Health Policy (2014) etc. But none of them have serious concern over the problem of mental health and wellbeing of children and adolescents in the school setting (Shastri, 2009). Some little steps are taken to improve the well being of students by various other institutions such as the ‘Happiness Curriculum’ that has been introduced by the Delhi government in over 1,000 schools between nursery to class 8. The entire curriculum is activity-based which includes yoga, meditation, exercises. It aims to stimulate a sense of self-concept, good mental health and reduce depression, anxiety among students (SCERT, 2019). School-based campaigns started by NIMHANS which aims to be increasing awareness about psychosocial disorders, self-awareness, and improvement in interpersonal relationships with peers and teachers (Vranda, 2015). CBSC has made it mandatory to have counseling services in every school but still, the most developed region of the country like NCR and other metropolitan cities, less than 3% of schools have counseling facilities. Schools charge hefty fees for services and are still not guaranteed whether the counselor is trained or not. They do not necessarily follow all the criteria for the recruitment of counselors (Thacker, 2018). On January 7th, 2014, the National Adolescent Health Action (RKSK) was recognized by the Government of India and implemented by the state government through the National Health Mission. Under such initiative of MHRD, recently the U.P. government has started the recruitment of school counselors in various KVS and other Navodaya schools (Johari, 2019). Although it has several limitations to address mental health issues, for instance, mental health is taken as taboo, and in reality; anxiety and depression are not taken as a serious concern in India (Roy et.al, 2019). Patients with severe mental disorders are stereotypically called Pagal (mad) here. So the people, especially students do not hold the courage to confront their situation in front of teachers, peers or even with family members. Counselors have the responsibility to identify such students and encourage them to share their feelings and problems. They should need continuous progression and training in their role and responsibility for school mental health promotion and special education for disabled children.

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A solution as a Holistic School-based Approach

Mental health is the main concern in this study so it broadly emphasizes the approach that needs to be focusing on students’ psychological, emotional, social health and wellbeing. Schools play a large role in the holistic development of students and provide a room and scope for interventions at all levels of the schooling extent. There is a need to boost students’ mental health at various levels of school. As we have already discussed the importance of rounded development of students to ensure their positive mental health, so it is necessary to collaborate and cooperate with all school stakeholders to make sure that the counseling programs and mental health activities are successfully implemented (Low et al., 2013). This is called the Holistic Approach which means the involvement of every aspect of school and/or people related to school incorporates to accomplish certain goals (Argyros, 2012). It is a concept that acknowledges the social, political, economic and demographic contexts within which schools operate and influence students’ psychological health. Teaching resilience, safety, and health education, the involvement of parents and community services and working on comprehensive mental health policies are the most important contributing factors of a successful holistic approach across all years of the schooling system. This comprehensive approach is globally recognized as working holistically to promote student health and wellbeing. The Holistic school approach ensures that all aspects of the school community contribute positively to students' health, safety, and well being. Several international initiatives from the WHO, UNICEF, UNESCO, and the International Union for Health Promotion and Education (IUHPE) use different terms to describe holistic, and comprehensive approaches address to the health and well-being issues among students, school staff and the wider school community. It is not just about what happens in the curriculum, but it is about the entire school day, it advocates that learning occurs not only through the traditional curriculum but also through students’ daily experience of life inside or outside of the school. It requires schools to address the health and wellbeing of their staff, students, parents/ guardians, and the wider community through the key components working in harmony to achieve improved health and wellbeing outcomes. It works on a theme that the good health of an individual cannot be attained just through their efforts, but health is also shaped by the surroundings within which he/she live, and work. By adopting this approach, schools can enhance the involvement of all stakeholders and increase the potential for sustainable development. Here are some recommendations to the school administrators and teachers to incorporate a holistic approach in their schools:

• The holistic school-based approach includes working together and being committed to all parts of the school. This requires teamwork among the government, school leaders, teachers and all school staff, as well as parents, and the wider community to achieve students’ overall health and development.
• The approach should encourage ongoing ‘comprehensive curriculum’ for the sensitization of principals, teachers, managers and all students towards the factors that can influence their mental health, like, Gender Issues, Substance Abuse Prevention, Anger management, Promotion of Emotional Health, and Safety as well.
• School systems must organize sequential age-appropriate programs and campaigns to spread awareness and responsibility about all dimensions of health and wellbeing.
• Life skills, health, and well being programs should be implemented for all students so that they become aware, accountable and empowered from all aspects of their personality and integrated with the standard of health and wellbeing.
• Trained counselors and special educators should be appointed to facilitate effective guidance and counseling for students as well as their families throughout their schooling. The right counseling and guidance help them to deal with their problems and also helps them to choose their academics and career effectively.
• There are a few most important things to consider for children with special needs i.e. early detection and intervention of the developmental problems and disorders are necessary as part of the specialized support to these children.
• The school should incorporate some parenting sessions in terms of child mental health, care and resilience training and awareness.
• Along with this, some capacity building programs for teachers and non-teaching staff should also be included to aware to the entire school about the sensitivity to child abuse and bullying.
• The mental health approaches should be designed to strengthen student abilities or skills using teachers as the facilitators in the schools in the following areas: promotion of positive mental health, enhancing resilience, handling academic stressors, practicing healthy lifestyles, prevention and handling sexual abuse, and bullying, developing healthy relationships, prevention of substance abuse, goal setting, prevention of suicide and developing values and life skills.
• Schools must have a measurable and sustainable Monitoring and Evaluation System (MES) for effective implementation of the life skills, mental health, values, behavioral and well being programs with dynamic indicators and the context of the changing scenario of the developmental, cultural and educational needs of the students.

Conclusion

Interactive and activity-based classroom sessions allow students to enhance their knowledge, attitudes, and skills essential for experientially promoting mental health and resilience, the results of which are expected to be sustained. Young people need to be taught how to regulate their emotions, deal with frustrations and failures, handle peer pressure and problems related to development, school and family in a healthier way which in turn would promote their mental health and resiliency. To support students in their mental health issues, it is important to reach all parts of the school community and beyond, because teachers, parents and other staffs all are integrated responsible for the development of students’ overall mental health and well being. A Holistic-school approach could be an ideal way to bring about changes to policy and practice to ensure everyone is fully on board, from governors to teaching assistants. Evidence suggests that schools with a whole school plan are more likely to have a positive impact on the mental health and wellbeing of pupils.

School-based interventions program has been increasingly recognized as an effective means of promoting the mental health of students and prevent the development of unhealthy behavior. Programs focused on competence enhancement of children and adolescents produced long-lasting positive effects on mental, social, and behavioral domains. Mental health problems among children and young people manifest in many ways, including emotional problems such as anxiety and depression, hyperactivity, conduct disorders, and peer problems. Not only do schools need to understand, and respond appropriately, to the wide range of symptoms displayed by children and young people, but they also need to understand the key role that gender plays in this.

Increased access to mental health services and supports in schools is vital to improve the physical and psychological safety of students, as well as academic performance and problem-solving skills at schools. School mental health supports that encompass social-emotional learning, mental wellness, resilience, and positive connections between students and adults are essential to creating a school culture in which students feel safe and empowered to report safety concerns, which is proven to be among the most effective school safety strategies. Additionally, school mental health professionals can provide supports that are sustainable, and can help to identify and work with students with their more intense or daily needs.