ESRC SEMINAR SERIES

1. ESRC SEMINAR SERIES The school as a location for the promotion and support of mental health University of Aberdeen 6 November 2008

2. Cause for Hope or Despair? The scope and limitations of children�s rights discourses in relation to contemporary developments in promoting children�s mental health and wellbeing in schools Vicki Coppock Edge Hill University

3. Outline The �problem� with being �critical� The debate: Cause for hope? Current policy and practice in CAMH and promoting �wellbeing� in schools Cause for concern? Conceptual, theoretical and evidential weaknesses Cause for despair? The State we�re in: the limitations of children�s rights discourses for achieving a child centred approach to mental health and wellbeing

4. The �problem� with being �critical� You�re always the �villain�! �It�s easy to be negative� �Nobody likes a smart arse�

5. Why it�s important to be critical The �morally-active practitioner� It opens the door to new ways of looking at, making sense of and responding to children and young people

6. Cause for Hope? �Everybody�s business� �Children�s mental health is the business of all the people, agencies and services in contact with children and young people� Every Child Matters (DfES/DH, 2003)

7. Cause for Hope? �Mainstreaming� mental health Emphasis on mental health promotion / prevention Resources

8. The �need� for a response? Epidemiological estimates of �diagnosable disorder� in CYP: 10% of those 5-15 in UK (Green et al, 2005) 20% of CYP in US (NAMH, 2006) 15-25% of CYP in Canada (Waddell et al, 2002) 14-20% of CYP in Australia (Sawyer et al, 2000) 2 million in the European region of WHO (WHO, 2005)

9. The �need� for a response? Children in �crisis� Parents not parenting Communities not caring Rampant individualism and materialism

10. The response SEAL (DfES, 2005) Healthy Schools Programme (DfES, 2005) NICE Guidance (2008) �School based mental health services reach children who do not receive help through other service routes� �with their �captive audience� and �(almost) total population cover��schools are the best placed institutions within which to centralize our holistic efforts� Rothi et al (2006 p.10)

11. A �Global� Issue? �Safe Schools Healthy Students� Initiative (US) �Take Action� (Canada) �MindMatters� (Australia) �Mentally Healthy Schools� �Mental Health Matters� (New Zealand) European Network of Health Promoting Schools Teenscreen (US); Kidscreen (EU)

12. Cause for Concern? Is it an unequivocal good? Reflects �linear� thinking (context deprived) Is the public health/education model the most appropriate? Is the school really a �natural� setting? Purpose of education / schooling? Culture and ethos? Teachers� concerns ignored

13. Theoretical coherence? Absence of serious debate / alternative perspectives Ignores contested nature of: conceptualisations of �childhood�, �family�, �mental health�, �wellbeing�, �disorder�, �illness�, �help�, �support� Developmentalism Medicalisation

14. The evidence base? Unquestioned assumptions abound Re-framing of medicalising and �psy� discourses as �wellbeing� Selective �hearing� of evidence e.g. CAMHS Review (Interim Report 2008; SCIE Research Briefing on ADHD 2004) What counts as �evidence� and who decides? The �deceit of ventriloquism� (Hendrick, 2008)

15. What works in building resilience? (Newman, 2004) Key factors promoting resilience in children are support from family and/or peers, good educational experiences, a sense of agency, of self-efficacy and opportunities to contribute to family or community life by taking valued social roles Children and young people who have experienced difficulties report more often being helped by non-professional supporters (friends and family), rather than by professionals. Professionals should avoid weakening informal sources of support.

16. Cause for Despair? The idea that promoting children and young people�s mental health and wellbeing in schools is consistent with their �rights� is heavily problematic in New Labour�s �Disciplinary State�.

17. Cause for Despair? �The Disciplinary State� (Hendrick, 2008) Characterised by: Early intervention Surveillance Discipline Punishment

18. Evidence of the disciplinary state? The Children�s Plan, December 2007 the dispersal of discipline � i.e. the �universal� approach the focus now on �potential problems� (as opposed to addressing structural issues! e.g. POVERTY)

19. Evidence of the disciplinary state? �in a world of ontological insecurity, social anxiety and emotional disarray, governing children is made to seem preferable to feeling at the mercy of unseen and impenetrable forces: risk in all its manifest forms� Hendrick (2008)

20. The Disciplinary State What happens to children and young people has little to do with their actual emotions or behaviour and everything to do with the wider social, political and economic context they inhabit.

21. The Disciplinary State �What a society judges as good or bad for its children depends on what it intends to make of them and the model to which it wants them to conform�thus a nation�s politics becomes the child�s everyday psychology� Sami Timimi (2005 p.2)

22. The Disciplinary State The persistence of adult/professional power structures that militate against children and young people�s agency Adults prepared to tolerate an increasingly narrow band of behaviour from children and young people Resistance to adult control is not an option for children and young people

23. Scope for Children�s Rights? Rhetoric and Reality UNCRC Report, October 2008 � the rhetoric of children�s rights in UK Govt Policy �culturally, Britain just doesn�t like children much� Time Magazine 26 March 2008

24. Models of children�s rights in services and welfare (Alderson, 2008) �Provision� and �Protection� Models of children�s rights dominate: Tiers of management and inspection restrict professional and child autonomy. Children �participate� at various levels, BUT origins, meaning, purpose, context, grounding of �participation� is vague.

25. What about the other UNCRC �rights�? �To freedom, privacy and autonomy? Objections include: too much for incompetent dependent vulnerable children threaten children�s �best interests�

26. UNCRC Article 12. When does a child become �capable�: �of forming his or her own views�; of having �the right to express those views freely in all matters affecting the child�; so that adults give �due weight� to children�s views �in accordance with the age and maturity of the child�; of being main and sole decision makers (Gillick 1985)?

27. The �problem� with rights (Alderson) are based on unreal Kantian concepts of pure reason, autonomy, decision-making, non-interference, ignoring social contexts and pressures are imperialist Western �universal� concepts, valuing physical and mental integrity, dignity and individuality over relationships and community pure autonomy - not totally realistic, realisable or desirable? all rights are qualified by respect for others, common interests, limited resources and, for children, by their best interests

28. Rights in discourse and rights in practice Nik Rose (1986) Rights-based strategies do not of themselves transform relations of dominance and subordination. Power structures must be brought into the open.

29. Tensions in children�s rights discourses in the mental health context Paternalism = adult professionally defined �problems� = adult professionally driven services = adult control Self-determination = cyp defined problems and solutions = �ordinary� sources of �help� and support for emotional wellbeing = cyp control

30. Tensions in children�s rights discourses in the mental health context The emotional distress and �wellbeing� of children and young people must be located in the structural reality of their experiences of exclusion and marginality

31. And� Hope for the future? Mainstreaming truly child-centred approaches Challenging narrow medical model Dealing with the messy contradictions inherent in adult-child relationships

32. And� Hope for the future? Academics / Practitioners who: Ask questions Recognise inadequacies Challenge oppressive structures