Reflect

An advert on the tunnel wall caught my eye. It’s core marketing message was that we should “care wildly”, a phrase that I mulled over for most of the day. How wonderful it would be if we all cared wildly about one another and cared wildly about making positive change in the world!

Personally, I have always cared wildly about enabling people to easily access evidence-based information. As a researcher, I passionately believe that some sort of guiding answer to any problem can always be found within research, or emerging research, and that it can shed light on pathways through any difficulty.

Over the last week, I have been steeped in the literature on eating disorders, self-harm and anxiety. I had been asked by a school to share what we know about these particular conditions in relation to children and, crucially, what schools can do to mitigate the tide of need. I can promise all readers that school leaders and school staff care wildly about children and can, understandably, feel powerless and concerned when faced with children or young people who are showing signs of mental distress.

Motivate

I will start with the words of psychiatrist, Dr Anna Conway Morris, who talked about the fact that, when it comes to managing anxiety and OCD, “parents are in such a good position to help their children”. Consultant clinical psychologist, Dr Sophie Nesbitt, who specialises in eating disorders, talked about the power of promoting emotional literacy in our homes and reminded us that eating disorders aren’t just about food, but are about feelings. Professor Ellen Townsend talked about the complexity of self-harm, but again, the one thing that I heard loud and clear from that discussion was that parental responses to children’s mental distress really does matter.

When a child is in distress, the natural reaction of most parents is to want to sort it out, quickly. Unfortunately, the courage it takes for a child to open up about how they are feeling can be unintentionally shut down by a shocked, angry, dismissive reaction or by a parent who wants to immediately solve their problem.

The key thing (universally reiterated by clinicians) is to first validate the child’s emotion. Before jumping in with reassurance (unlikely to work) or solutions (unlikely to be viewed as helpful in the moment), we need to simply hear what the child has said.

So, what does “validating their emotion” actually sound like? Try, “I can understand why that would be distressing” or, “That sounds really hard. Thank you for telling me”. These deliciously validating sentences provide a foundation of trust between parent and child. There is an absence of over-reaction and the beginning of gentle collaboration.

Many parents struggle with their facial responses when they hear difficult news. A very natural response to finding out that your child has self-harmed (for example) is to gasp in horror and alarm. But the one thing I have learned this week is that, if a child does disclose something about themselves and how they are doing or feeling, we must do everything we can to reduce any shame, guilt or stigma.

The last thing that any parent wants is a child who harms their own bodies in secret. Secrecy seems to be a breeding ground for both self-harm and eating disorders. Parental reaction, when negative, may inadvertently exacerbate deep-rooted feelings of shame and discourage further disclosure.

No matter the mental health condition, we do our best for our children when we assume the role of active listener, understanding responder and compassionate collaborator. Our children have a better chance of making it through distress when we respond with unconditional love and a commitment to working through it together.

Support

Body dissatisfaction, defined as “negative subjective evaluations about one’s physical body, such as figure, weight, stomach and hips”, is the commonest risk factor for eating disorders, yet, as Professor Phillippa Diedrichs commented during a recent ACAMH conference on eating disorders, it is also “the most potent modifiable risk factor”.

Read: this is something we can do something about. By emphasising body gratitude and body capability at home, and by paying markedly less attention to appearance, we can make positive steps towards early intervention. Schools can do their part too. Rigorously evaluated programmes such as Confident Me can be delivered by teachers over a series of lessons, are available in eight languages and cost nothing.

A range of resources can be confidently signposted to parents that we know will have a tangible impact on younger children’s body confidence. The e-book, Your Magic Mind and Body, the YouTube video series “We Deserve to Shine” (masterminded by the Self-esteem Dove project) and the interactive game, Self-esteem Squad have all been highlighted as effective ways to boost children’s positive appraisal of their bodies. 

When it comes to stemming the tide of mental health concerns in children, the time has come to diffuse responsibility between home and school, parent and practitioner, and for us to collaborate positively for the sake of children and young people everywhere.