Mental Health and Wellbeing
Role of Teachers
SINANDIGAN ELEMENTARY SCHOOL
MID-YEAR INSET 2023
February 6-10, 2023
8:00-5:00 PM
Jasmin E. Vallentos, Ed.D. (CAR)
Mental Health and
Wellbeing
‘Health is a state of complete physical,
mental and social well-being and not
merely the absence of disease’ (WHO, 2008 – Mental
Health)
Wellbeing: Reflects values, norms human
needs etc. as perceived by people
themselves (Diener and Suh, 2000; Prlleltensky et al. 2000; Myers et
al. 2005).
Mental Health and Wellbeing
Understandings of ‘mental health’ and ‘mental
illness’ determined by meanings given to
experiences and feelings in a context of people’s
culture (Marsella and White, 1982; Kakar, 1984; Kleinman, 1988a,b; Gaines,
1992; Fernando, 2002).
Mental health is not just a technical matter but
connects with ways of life, values, and worldviews
that vary across cultures.
Understanding of ‘wellbeing’ (in development
studies) reflects range of human experience -
social, mental, spiritual, material. (Chambers 1997).
Community perceptions of mental
health and wellbeing
Material wellbeing
Social wellbeing
Security
Physical, mental and
moral/spiritual wellbeing
Material wellbeing
having stable
employment/livelihoods
having stable cash incomes
access to adequate land
having permanent, secure and
spacious house
Social wellbeing
providing good education and
socialization for children
caring for children
unity and harmony within family
unity and harmony within
community
unity and harmony with
neighbouring communities/host
communities
Social wellbeing
access to services
self-respect and dignity
clean and free environment
free of alcohol and drug
abuse
Security
a secure environment for their living
without fear and outside threats
a secure physical environment and
protection from natural disasters and
conflicts
free movement and living without being
subject to suspicion
Security
a peaceful atmosphere free of regular
checks and intimidation from security
forces.
secure and strong houses to prevent
intruders
houses that ensure privacy and personal
safety
community members coming together to
intervene and resolve problems and issues
Physical, mental and moral and
spiritual wellbeing
living without illness and suffering
living without illness and suffering
having mental happiness
having good thoughts/feelings towards others
living with courage/endeavour, self-initiative
and drive
living with wisdom (not acting on
emotions/rational behaviour)
moral behaviour of community members
careful spending
living religiously
What reduces community
mental health and
wellbeing?
political violence and natural disasters
displacement
poverty
poor housing conditions
conflicts within family and community
social exclusion and isolation
What reduces community
mental health and
wellbeing?
injustice and discrimination
urbanization
communicable diseases
work stress
alcoholism, drug abuse and sexual
abuse
Psychosocial context of
mental health and wellbeing
(source: Prof. A.J.Marsella)
Factors affecting mental Implications for mental
health & wellbeing health & wellbeing
Cultural abuse, destruction and Confusion and conflict
collapse
Oppression and domination Anger, hate & domination
Humiliation Rage and revenge
Powerlessness Helplessness and despair
Poverty Hopelessness and misery
Denigration Low esteem and worthlessness
Racism, sexism and agesim Fragmentation and restrain
opportunity and denies choice
Stigma
People with mental health problems (studies in UK)
84 % experience problems in getting jobs, healthcare, mortgages
(Mind survey, 2004)
55 % young people would not want anyone else to know about illness
(NUS and Rethink, 2001)
49% have been harassed or attacked
(Mind, Not Just Sticks and Stones, 1986)
33% report having been dismissed or forced to resign from jobs
(Read and Baker, 1996)
Source: Dr Suman Fernando
Stigma – research
Stigma absent when mental illness is attributed to
‘spirit possession’ (in Sri Lanka)
(Waxler, 1974)
‘brain-disease’ view of mental health problems
increases stigma (in Germany)
(Angermeyer and Matschinger, 2005)
‘bio-genetic cause’ view of mental health problems
positively related to stigma
Source: Dr Suman Fernando
Social costs and stigma
Social costs of illness are high in terms of family breakdown, isolation,
disharmony, poverty and deprivation
Social stigma prevented many patients and their families seeking
treatment from ‘Angoda hospital’
Many patients preferred to go to general hospitals (psychiatry units) or
private hospitals/doctors to avoid getting them labeled
Forceful admissions result in anger and hostile relationships between
patient and families
Source: Dr Rasitha Perera
Family response to persons with mental
illness
Care givers were reluctant to take the patient
home and desired a long stay when
patients:-
were aggressive at home
do not take treatment as prescribed
mess up family/home affairs
do not have a care giver at home
Dr Rasitha Perera
Family response to persons with mental
illness
Care givers were reluctant to take the
patient home and desired a long stay when
patients:-
are dependent on others / lack of productivity
misuse psychoactive substance
show hostility
maintain poor self care
Source: Dr Rasitha Perera
Family response to persons with mental
illness
Illness was the major cause for many patients to remain single,
separated or divorced
50% of the patients experienced disharmony with their families
1/3rd of the patients were considered a burden to the family
Only 1/4th of the patients received better family care
1/3rd of the care givers were not satisfied with the current status of
the patient
Source: Dr Rasitha Perera
Promoting mental health
and wellbeing
Interventions
Social
Medical (treatments)
Strengthening resilience and support
Individual
Family
Community
Promoting recovery (‘recovery approach’)
Developing hope
Overcoming barriers
Social inclusion
Source: Dr Suman Fernando
Mental Health
Interventions
Medical model:
Problems identified by symptoms of
individuals
‘Illness’ represents bio-medical
pathology
Source: Dr Suman Fernando
Mental Health
Interventions
Medical model:
Help is via individual treatments
- Biological (medication, ECT)
- Psychological (e.g. ‘talking therapies’, CBT )
Environmental manipulation e.g.
therapeutic communities, advice,
education, family support
Source: Dr Suman Fernando
Mental Health
Interventions
Social model:
Origin / cause of MH problems are
social
‘Illness’ is socially constructed
Help is via social interventions and
support involving family, community,
living conditions etc.
Source: Dr Suman Fernando
Healing systems accessed by people
in Sri Lanka
Western medicine including psychiatry
Ayurvedic, siddha and sinhala medicine
Astrological consultation – palm/ horoscope
reading
Healing rituals – bodhi pujas, exorcism
Practical advice based on dhamma – pirith
chanting, medication
Healing at temples, churches and mosques
Mental health promotion
develop ‘balanced care’ = hospital care +
community care (mixture of medical and social
models)
Work as multi-disciplinary teams
support traditional healing systems
promote family and community support
integrate with community development
social inclusion and participation
reduce risk factors
Recommendations for developing
community-based mental health
services
Principles:
Bottom-up approach:- ‘home-grown’
Involve local community organizations (e.g. schools,
temples, churches, mosques, etc. )
Culturally and socially acceptable/sensitive
Include marginalized groups
Integrate local knowledge with outside ‘expertise’
Ref: Weerackody and Fernando, 2009
Factors affecting mental
health and wellbeing of
children
Lack of access to education and facilities
Child neglect, ill-treatment and poor care
Malnutrition
Traumatic experiences – loss of family members,
displacement, detention, physical injuries
Substance abuse
Sexual abuse and child prostitution
Child trafficking and labour
Domestic violence
Factors affecting mental
health and wellbeing of
children
Family break downs e.g. divorce,
separation, desertion
Recruitment as child soldiers
Parents working abroad
Competition and pressures for
‘achievement’
Disabilities
Mental health problems
of children (1)
May present as:
emotional problems such as phobias,
excessive anxiety, depression, irrational fears
Unusual behaviour / conduct such as
aggressiveness, timidity
Inattention / overactivity at school or home
Mental health problems
of children (2)
May present as:
Difficulties / delay in acquiring certain skills such
as speech, writing, reading
Problems in attachment to parents or caregivers
such as not showing or responding to affection
(when severe may be autism)
Food fads / eating problems such a refusing to
eat, induced vomiting (may be anorexia)
Mental health problems
of children (3)
sleeping problems such as excessive
sleepiness, insomnia (may be sign
of more severe illness)
Post traumatic problems such as re-
living traumatic incidents (may
become ‘post traumatic stress
disorder’ – PTSD)
Dealing with Mental health
problems of children
Try to pick up:
Special needs that child may have such as
early learning difficulties, dyslexia
(recognition of words and writing letters),
hearing loss (early deafness), visual
impairment
Problems in the child’s interactions with
other children, teachers and others in
authority
Dealing with Mental health
problems of children
Family problems at home
Difficulties in socialisation (not
mixing, isolating)
How can the teachers
help?
Paying more attention to children with
special needs or ‘problems’ (20-30
percent of children)
Providing a safe context for children to
talk
Listening and talking to children
How can the teachers help?
(2)
Making referrals to relevant specialists
(e.g. children with severe emotional
disturbance, post traumatic states,
eating disorders, deafness, autism,
family issues)
Enabling children to develop appropriate
life-skills, self-esteem and resilience
Prevention of mental
health problems (1)
Acquiring professional skills in
understanding child development and
mental health
Creating a supportive school
environment that is conducive to
learning and developing life skills
Providing mental health education,
knowledge, attitudes and behaviours
to all children
Prevention of mental
health problems (2)
Educating parents and community
members on risk and protective
factors of mental health
Identifying factors that place children
at risk and reinforcing protective
factors
Challenges for teachers
How can we provide a safe and
supportive environment in which all
students can maximize their learning?
How can we remain accessible and
responsive to their needs?
How can we assist our students to
develop their ability to cope with
challenges and stress?
Providing supportive
context for children
Liaising with families, parents and care-
givers e.g. home visits
Fostering partnerships between school
and community agencies, service
providers etc.
Strengthening community support
networks
Factors that enhance
resilience among children
Positive role models
Positive self-esteem
Supportive relationships with teachers
and friends
A sense of hope and purpose
Belief in one’s self
Strong social skills
Good peer relationships
What are Life-Skills?
Skills that enable people to:
Live in harmony with parents, teachers and others in authority
Live in harmony with peers from various communities and social
classes
Make socially & culturally appropriate relationships
Make decisions that are in keeping with social and cultural norms
(ethical values, expectations of kith and kin, worldviews, etc.)
Maintain a sense of self-worth as well as respect for others
Deal with adversity in socially acceptable and culturally appropriate
ways
Specific Life-Skills
Specific skills would depend on
social and cultural context in which
the person lives – so would vary and
the specifics of the skills required
would change as society changes
and / or person moves (e.g.
migrates)
Western and Non-Western
Understandings of Life Skills
Western Non-western
Decision-making and problem solving
analyzing information and adherence to cultural norms and
experiences objectively and making seeking guidance from elders and
decisions based on facts spiritual influences
Communication
ability to express views and indirect expression of views,
opinions directly respecting views of other people,
and dependence on family
Independence
Depend on oneself primarily and respecting opinions of others and
maximize self-confidence more accepting of dependence on
others
Western and Non-Western
Understandings of Life Skills
Western Non-western
Coping with emotions
Recognizing emotions, wide cultural variation in
controlling emotions and expression of emotions and
expressing emotions in need to control emotions
acceptable ways
Coping with stress
Understanding causes of cultures vary a great deal in
stress and controlling stress ways of dealing with stress –
some prefer acceptance of
control
