Mental Health Matters by Nagel Paula;

Author:Nagel, Paula;
Language: eng
Format: epub
Publisher: Bloomsbury Publishing Plc
Published: 2016-08-15T00:00:00+00:00

Step 4: What is the mental health message?

Given what we now know about Shaheen, can we identify any emerging mental health challenges, or an increased vulnerability of developing mental health problems? What are the risk factors and warning signs?

Key points from the consultations

•Shaheen’s withdrawn and avoidant behaviour is becoming more apparent in school.

•She is reluctant to try new activities and tasks and hangs back from new challenges.

•She can interact with the other children but often appears to choose not to, preferring to do her own thing.

•Sometimes she can be easily led and does things that other children tell her to do.

•She has been accused of taking things from others, but she denies this when asked.

•She is not motivated by praise or reward.

•She prefers predictability and routine.

•She is doing well academically, and has no speech and language difficulties. Her difficulties are not thought to be part of an autism spectrum disorder.

•She has lived with her maternal grandmother since the age of two.

•Her mother has mental health and addiction problems.

•Shaheen says she likes to be kind and helpful, get things right and have special jobs to do. She doesn’t like getting things wrong and prefers it when she is clear about what she has to do or what is going to happen next.

Could her behaviour reflect any emerging mental health problems?

Emerging mental health problems – risk factors and warning signs

1. Withdrawn and avoidant behaviour

Shaheen’s withdrawn and avoidant behaviour is becoming more apparent as she gets older, and could indicate emerging mental health issues. School staff have monitored Shaheen’s behaviour since Reception. They know that some children may be quieter and more anxious when they start school until they gain more skills and confidence. However, Shaheen’s withdrawal is worsening and no longer seems to be developmentally appropriate. Some of her behaviour could be described as anxious. Children can feel anxious for a number of reasons, sometimes because of learning difficulties or disabilities, communication needs or perhaps due to traumatic events or their early experiences. School staff have considered the possibility of these factors and don’t think she has any communication or learning needs. However, we know from school information, and from her gran, that Shaheen has had a disrupted early childhood. Sometimes children who have experienced disrupted parenting can display behaviour linked to insecure attachment, and Shaheen’s avoidant and withdrawn behaviour may indicate attachment difficulties.

2. Disruption to early childhood

The disruption to Shaheen’s early childhood is a risk factor for mental health problems. Although we don’t know all of the details, we know that she was removed from her mother’s care at the age of two. It is likely that Shaheen’s experience of early parenting has been disrupted and disordered. She may not have had the opportunity to establish a close, nurturing relationship with her main caregiver in her early years. Even though she was placed in her gran’s care at the age of two, we know that disrupted caregiving in infancy can have a long lasting impact on how children relate to others, and how they understand relationships and emotions.

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