Mental health exists on a continuum, so we need to teach young people how to obtain and maintain good mental health. The approach to include mental health education and literacy in schools needs to be targeted to suit youth needs, proactive and educational not clinical in nature. 

Consult!

Firstly, young people need to be consulted with. Our research has found young people find schools reactive in times of crises. Preventative approaches are rarely taken to support youth wellbeing. Young people could be included through school advisory groups, student surveys, and co-development of programs. Taking into account needs consistently throughout the school year will help to ensure student voice is heard, and MHL programs and mental health education are tailored to what they are identifying as gaps in their knowledge. 

Educate!

Secondly, the aim of mental health education and MHL program is not to diagnose or teach young people the diagnostic criteria for a mental health disorder. Rather, it is to educate young people on what, for example, anxiety is, how to recognise it and what to do if you experience it. Low mood and feeling anxious can be in reaction to certain life stressors. Young people need to know how to cope with this. When feeling anxious becomes a persistent dread and impacts everyday functioning, young people should know to talk to a trusted adult or health professional. A MHL program can help to teach young people this. 

YES (Youth Education and Support)

Our MHL program, Youth Education and Support (YES) was adapted and developed to suit Australian youth needs. We included youth voice during the development, consulted educators and allied health professionals working with young people. We framed it based on an evidence-based model. The universal design for learning, and the health curriculum were also used to align the program within the current system of education. What we have learnt so far of the YES program is:

• There has been an increase in MHL after participation
• Young people have found the program interesting, educational and helpful
• Schools want MHL to be included in their learning

Healthy coping

A large focus of the program is teaching young people healthy coping skills, and how to seek and give help. Although schools tell students how to access onsite counselling or psychological support, this information is not always retained by students. Consistent education and reminders of the support across the years is important for young people. 

By building their knowledge from primary school years up until the end of secondary school, their understanding of MHL can be broadened and different topics suitable to age can be targeted. For example, during primary school the focus may be on understanding emotions, and understanding the fight, flight, freeze and fawn response. 

How to seek help

For the upper secondary school years, it may be about coping during exam time, identity formation, and understanding where to seek help once they leave the school environment (for example,  how to seek help from a psychologist or counsellor). However the target for each year level should be based on consultation with key stakeholders, including young people, and professionals working with young people such as educators, psychologists and/or wellbeing staff. 

For mental health education and MHL to be successful, evidence-based interventions or evidence-based curriculum needs to be included. 

Stigma still exists

Evidence-based practice is not new in education and government policy, and helps ensure better outcomes for communities and services provided. Education also does not exist in a vacuum. The school environment plays a role in shaping MHL, particularly attitudes towards mental health. Stigma still exists towards mental health and mental illness, and is a major barrier for young people to seek help and solve mental health problems. 

Increasing awareness of mental health can help to ensure young people hold a positive attitude towards mental health. Strategies include fostering a positive classroom climate, and discussing help seeking options with students. Increasing awareness does not mean teaching young people the DSM-5. Providing mental health education in a safe and non-judgmental space could help those who are significantly struggling seek help sooner. 

Feeling alone

Many young people feel alone in their personal experiences. Normalising different emotions and providing healthy options to cope could benefit young Australians in future. For this to happen, the workforce supporting young people in schools needs to be strengthened.

Teachers are overworked, and do not have the necessary training or confidence to deliver mental health education and MHL currently. 

But this could be rectified by a mental health education curriculum as part of the health curriculum. Teachers could be trained to teach, with mental health professionals supporting teachers to do so. This will require government bodies to consult with experts in the field of youth mental health, MHL and education to firstly develop the curriculum. Universities will need to include this content in their degrees, and then evaluation needs to occur throughout. This is no small task. But it could make an invaluable difference to the mental health and wellbeing of Australian young people. This is not offering intervention, therapy or counselling services.

A step forward

A step forward includes comprehensive mental health literacy, ensuring the curriculum covers the core aspects of mental health theoretical framework, tailored to be age-appropriate and culturally sensitive. 
Does focusing on diagnostic models of mental health in mental health programs lead to more harm? We’re exploring this question in the working group at the University of Oxford, to identify if these approaches further stigma.

From left to right: Christine Grove is adjunct associate professor, Monash University School of Medicine, Nursing and Health Sciences, Vice-Chancellor Research Fellow (Advanced), School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia and a Fulbright Fellow. Alexandra Marinucci is a research fellow, School of Health and Biomedical Sciences, RMIT University.