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Student mental health – What schools can learn from the world’s healthiest countries

Photo of teenage girl in school uniform wearing medical mask and applying hand sanitiser

With the number of students experiencing mental health difficulties continuing to grow, let’s try adopting the habits and practices of some of the world’s healthiest regions, suggests Dr Nick Smith…

Dr Nick Smith
by Dr Nick Smith
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A recurring belief of older generations is that ‘growing up nowadays is far easier than in the past.’

After a particularly fractious half-term holiday earlier this year, when both of my children displayed a complete lack of appreciation for their fantastic, sparkling lives, I briefly became a paid-up member of this school of thought.

Upon my return to school, I gave an assembly entitled ‘When I was your age, things were very different’ that saw me outline the many ways in which I viewed my childhood as having been tougher than theirs.

I pointed out that, unlike them, I hadn’t received constant technological stimulation, and had therefore learnt to amuse myself for hours on end with something as simple as a stick, a piece of string, or – a particular favourite – the humble paperclip. Nor had there been any ‘fancy’ food when I was growing up. In place of kale and quinoa, I’d been fed beef dripping instead. I had no idea what an avocado was.

Greater mental strain

And yet, while I continue to believe that growing up in the past was perhaps more physically demanding than today, it’s also become clear to me that the younger generation are under far greater mental strain than we ever were.

They feel under increasing pressure from a world full of rampant consumerism and celebrity culture. It’s a world in which they must strive for physical perfection and stunning success on all fronts. When they fail to meet these lofty expectations, many aren’t equipped to cope and can become ill as a result.

According to DfE figures, in 2017 more than one in three teenage girls suffered from anxiety or depression – a rise of 10% over the previous decade. Our students are the first generation to have lived their lives fully in the digital age. For them, there is no escape from an unceasing, yet addictive 24-hour online culture that constantly reminds them of the unobtainable expectations society has set for them, and a relentless stream of peer judgement via social media.

Many lack the direction and stability that faith and family might have previously provided – and if that wasn’t enough, the climate of the world outdoors is changing at a precipitous rate. Physically, things are scarcely any better for them either, given a stark increase in childhood obesity and associated diabetes that’s been described as a modern-day epidemic.

Blue zone thinking

The problem for our students is that previous generations have created a world where staying healthy has become surprisingly difficult, and hence increasingly unusual. When I was growing up, we ate plenty of vegetables, and walked or cycled almost everywhere. In the post-internet era the lives of our teenagers look very different indeed, faced as they are daily challenges to their physical and mental wellbeing.

Our initial attempts to counter these trends resulted in an explosion in the quantity and range of support personnel employed within schools. Over time, we’ve utilised a whole host of pastoral heads, counsellors, nurses, safeguarding officers, SEND personnel, mental health practitioners, student mentors, catch-up coordinators and Pupil Premium champions, alongside help from a wide range of external agencies.

Remarkably, however, it never seemed to matter how much we increased our capacity – it was never enough. The demand always seemed to grow to the point where it would swamp our supply. Eventually, I came to realise that this was because our army of pastoral operatives were only really treating the symptoms of the issue rather than its causes.If we wanted to staunch this flow of ill health, we would need to head upstream.

Thus, it seemed to me that the principal challenge for schools was to rebalance academic learning with emotional wellbeing. Having resolved to do this in our setting, I opted to implement a whole school health curriculum based on the work of geographer Dan Buettner at National Geographic.

Buettner had led a study into the five places in the world where people live the longest, and exhibit the lowest levels of chronic disease. It turned our that these places were to be found in Japan, Italy, Greece, Costa Rica and California, and came to known as ‘Blue Zones’.

Buettner and his research colleagues were surprised to discover that despite these long-lived Blue Zone communities being many miles apart from each other, they all shared a number of similar habits.

For example, their populations all had a strong sense of purpose and belonging. Family was the priority around which they built their lives. They would set aside time in the day for escaping the commotion of daily life, and had adopted routines that helped them shed stress.

People in these areas would also eat moderate amounts of fresh, unprocessed local produce, made mainly of plants. Instead of going to the gym or training for marathons, the exercise these people did stemmed mainly from movements that simply arose in the course of their daily lives. They would walk to most places. They consistently used the stairs. They would perform household chores by hand, and regularly dug, hoed, weeded and harvested their gardens.

Focus on health

Since moving our students to a Blue Zone was impractical, our response was to instead develop a modified version of those Blue Zone habits, and codify these via our school’s own ‘10 Healthy Habits’ (see panel). My hope was that this would not only make our students healthier, but happier as well.

To realise this ambition, we focused our curriculum as much as possible on health. We created a quarter-mile circuit through our grounds, and set our students the task of walking around it a certain number of times each half-term.

We also asked students to choose four friends to form social support groups, based on the lifelong friendship groups in Japan known as Moai. We provided tai chi and yoga sessions. We introduced a no cake/biscuits policy in lessons, and laid on food choices typical of Blue Zone regions in our canteen.

We introduced dozens of new extracurricular activities, including a gardening club, organised lunchtime student games and mid-lesson movement sessions. We set aside a designated quiet/meditation area and even created a Blue Zone recipe book.

By offering these different curricular experiences, we hoped to encourage our students to make small, but persistent changes that would gently nudge them towards lifelong healthy habits.

For all the progress we’ve made, however, our ability to adopt wholesale the kind of curriculum outlined here remains problematic, since it requires two major changes in governmental policy – the freedom to escape the straitjacket of an exam-orientated curriculum, and the funding necessary to staff a major cross-curricular programme of physical and mental wellbeing.

If both were to be implemented, it would not only help schools counter the rising tide of childhood illness, but it would be the single most important investment any government could make.

Dr Nick Smith (@DrNickSmiff) is a retired headteacher, having previously led Torquay Girls’ Grammar School, and taught at four comprehensives, one FE college and a grammar school prior to that

This article is an adapted extract from his book Head Trauma – The Bruising Diary of a Headteacher, available now (£16.99, Michael O’Mara Books)

10 Healthy Habits

The full list of ‘Blue Zone’ healthy habits adopted by Torquay Girls’ Grammar School…

1. CREATING – A healthy planet

2. LIVING – Have a sense of purpose

3. CHILLING – Relax and de-stress

4. LOVING – Put family first

5. BELONGING – Take part in a community

6. CHOOSING – Choose healthy friends

7. FEEDING – Eat fresh food in moderation

8. PLANTING – Eat more plant-based food

9. MOVING – Move naturally

10. SNOOZING – Get sufficient sleep

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