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Big story: mindful from the start?

09 May 2019

With mindfulness exercises set to be among techniques taught in a government-led trial across primary schools, journalist Juliette Astrup asks about the growing interest in mindfulness and how it can help support children’s wellbeing.

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Mindfulness – a state of being fully present and aware in the moment – has become a familiar wellbeing goal in recent years, and techniques and approaches to help cultivate it increasingly popular. With more than 1000 mindfulness apps available to download, including field-leader Headspace, taking a ‘mindful moment’ is now
a familiar practice.

With a growing body of research into the potential benefits for mental health and wellbeing, and the proliferation of mindfulness training in workplaces and academic institutions, mindfulness has made the leap from ‘alternative’ to mainstream. That status is reflected not least in the formation of the Mindfulness All-Party Parliamentary Group (MAPPG) in 2014, with the purpose of reviewing evidence, best practice and applications of mindfulness in order to develop policy recommendations for government. In short, it is a wellbeing tool that is being taken seriously across a range of spheres.

It follows then that mindfulness exercises are among the mental health interventions being trialled in a new Department for Education-commissioned study in England. Led by the Anna Freud National Centre for Children and Families, the Education for Wellbeing programme, one of the largest in the world of its kind, will involve 370 schools in England. It will include the teaching of mindfulness-based skills to Year 7 and 8 pupils (aged 11 to 13) for five minutes daily, as well as relaxation and breathing exercises, and sessions with mental health experts. Running until 2021, it aims to provide robust new evidence about what schools can do to best support students’ mental health and wellbeing.

 

The case for mindfulness

Only time will tell what this study will reveal, but there are many already convinced of the benefits of mindfulness for children, and at an even younger age than 11 – and of the pressing need for such an intervention.

It is widely perceived that we are in the grips of a child mental health crisis in the UK. One in eight (12.8%) five- to 19-year-olds in England have at least one mental disorder according to NHS Digital (2018). Pitchforth et al (2018) saw reports of child and youth mental health disorders in England and Scotland grow by 60% and 75% respectively between 2008 and 2014, and in Wales reports of treatment for a mental health condition rose by 41%.

The latest figures show the prevalence of emotional disorder in five- to 15-year-olds in England rose from 4.3% to 5.8% over the same timeframe (NHS Digital, 2018). Children, especially teenagers, are turning to self-harm and suicide (The Children’s Society, 2018). 

As for mindfulness benefits for children, there is a growing evidence base showing the potential of mindfulness-based interventions to have a positive impact on stress and anxiety in children (for example Kallapiran et al, 2015). 

And more schools are beginning to adopt such approaches; the Mindfulness in Schools project already works with dozens of schools across the UK. It has programmes for children as young as seven – but is there an argument for starting younger? 

 

The earlier the better?

Psychologist and writer Dr Richard Sly believes so. He is teaching mindfulness and meditation practices to his two young boys aged six and four, and wrote an article in the Times Educational Supplement on ‘Why we need to teach four-year-olds mindfulness’ (Sly, 2018).

‘I think we like to imagine childhood as being some kind of halcyon existence, but the reality is that even very young children are exposed to stressful situations such as the intricacies of playground politics, or of learning at a faster or slower rate than their peers,’ he explains. ‘Perhaps from an adult point of view such things may seem trifling, but from the perspective of a child, these questions of “Am I good enough?”, “Am I stupid?” and “Am I likeable?” are tough ones to wrestle with, particularly because at a young age they don’t have the tools to manage these emotions and concerns.’

He goes on to say that this has been illustrated in a number of studies. ‘For example, a survey by The Key [2017] shows alarming rates of primary school-based stress and anxiety,’ he says. ‘And a House of Commons-led committee concluded that SATS tests place children in a high-stakes system that is damaging to their mental health [House of Commons Education Committee, 2017].’

Richard points out that he has seen this at first hand in his son’s anxiety levels. ‘My wife is a mental health professional and mindfulness teacher, and delivers courses for both adults and children. We could see the differences that could be made and, crucially for me, the evidence of scientific studies all pointed to this approach being acceptable for children, easily accessible to them, and of great benefit too.’

His family uses the ‘Relax Kids’ resources, and while the approach is not infallible, he says ‘there have also been plenty of occasions in which they have managed to recognise difficult feelings and proactively manage them’.

And when it comes to the question of ‘the earlier the better’, he says: ‘It’s great that this is now being trialled in schools, but these things take a long time to come to fruition.’ Richard began teaching his children mindfulness at four. ‘This is the time at which they are like little sponges, and learning habits and strategies early is a good thing that can make a great difference.’

His advice? ‘I’d encourage every school to think about having a set part of the day in which they access resources with kids about mindfulness. A quick few minutes every day can make such a difference.’ 
 

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Who, when and where?

Janine McKnight-Cowan, project health visitor and Queen’s Nurse, Derbyshire Community Healthcare Services NHS Trust, agrees that the idea of children practising mindfulness is ‘a particularly positive tool’, and there is a real need, given that children now lead such complex lives, dealing with problems such as ‘divorcing parents, stressed single parenting, poverty, and the sheer overload of digital technology’.

‘Learning how, when and where to find calm headspace could be the answer to reducing the stress and negative behaviours shown by children exposed to negative lifestyles,’ she adds.

However, having the right provision and resources to deliver such an intervention are key.

‘Who teaches it and when and where it is used is the concern,’ she adds. ‘Health visitors have so many key targeted outcomes, to expect them to take on another mindfulness session with children would need more resources and more time. Perhaps they are the wrong people to expect to train and deliver this tool.’

In her opinion, a nursery setting, where a child can ‘build up a relationship with a carer and mindful coach,’ may be able to deliver it ‘more realistically’. 

But is mindfulness even graspable for children so young? A study of the efficacy of mindfulness among 47 pre-school children suggested higher vocabulary and reading scores among a mindfulness group compared with a control group (Thierry et al, 2016). 

It is at least possible to ‘teach the infant mind to protect itself’, believes Janine, adding: ‘Techniques can be fun, but need to be learnt and consistent if they are to be effective.’

While it may prove to be a useful tool in the mental health armoury, mindfulness-based interventions are far from a panacea. Undoubtedly the bigger challenge is addressing the causes of stress and anxiety blighting the lives of children in the first place.

 

The bigger picture

Natasha Devon, author of A beginner’s guide to being mental: an A-Z, works with schools supporting mental health education. She says mindfulness has a place – but shouldn’t be regarded as a ‘magic bullet’.

‘What children need are regular exercise, a place to relax and creativity – all of which are proven to restore the chemical balance of the brain and lessen some of the toxic effects of stress and anxiety,’ she says. ‘I definitely think mindfulness has a place within the relaxation side of that – but you need to look at what is going on in children’s lives that means they need mindfulness in the first place.’

One fundamental that practitioners such as health visitors might be well placed to address is how the adults around children cope with their own stress.

Natasha says: ‘I think one of the biggest contributors to young people’s poor mental health is that a lot of their parents and teachers are struggling with their own mental health. They are incredibly stressed, incredibly busy. Both in schools and at home you can almost feel everybody vibrating at a frequency of stress.

‘Up until the age of seven, children are absolutely myopic in the way they view the world. If the adults around them are using a lot of stress language, very fraught and frantic, never taking a time to pause or use their imagination – you can guarantee that’s teaching them something.’

She adds: ‘In just the same way as we teach them about their physical health, we need to teach children that they have a status of mental health and there are things they can do to look after it. But there needs to be a balance between having that attitude and burdening children – especially young children – with that responsibility when they don’t have any control over their environment. It’s so important to support the parents as well – and it has to go beyond mindfulness.’

Even if mindfulness doesn’t provide all the answers, its potential to help children manage stress and anxiety is perhaps something we should all be mindful of. All while keeping the bigger picture in mind. 


References

Anna Freud National Centre for Children and Families. (2019) One of the largest mental health trials in the world launches in schools. See: https://www.annafreud.org/insights/news/2019/02/one-of-the-largest-mental-health-trials-in-the-world-launches-in-schools (accessed 2 May 2019).

House of Commons Education Committee (2017). Primary assessment. Eleventh report of session 2016-17. See: https://publications.parliament.uk/pa/cm201617/cmselect/cmeduc/682/682.pdf (accessed 5 April 2019).

Kallapiran K, Koo S, Kirubakaran R, Hancock K. (2015) Effectiveness of mindfulness in improving mental health symptoms of children and adolescents: a meta-analysis. Child and Adolescent Mental Health 20(4): 182-94.

NHS Digital. (2018) Mental health of children and young people in England, 2017. See: https://digital.nhs.uk/data-and-information/publications/statistical/mental-health-of-children-and-young-people-in-england/2017/2017 (accessed 5 April 2019).

Pitchforth J, Fahy K, Ford T, Wolpert M. (2018) Mental health and well-being trends among children and young people in the UK, 1995–2014: analysis of repeated cross-sectional national health surveys. Psychological Medicine (online). See: https://www.cambridge.org/core/journals/psychological-medicine/article/mental-health-and-wellbeing-trends-among-children-and-young-people-in-the-uk-19952014-analysis-of-repeated-crosssectional-national-health-surveys/AB71DE760C0027EDC5F5CF0AF507FD1B#fndtn-metrics (accessed 17 April 2019).

Sly, Richard. (2018) Why we need to teach four-year-olds mindfulness. See: https://www.tes.com/news/why-we-need-teach-four-year-olds-mindfulness (accessed 29 April 2019).

The Children’s Society. (2018) The good childhood report. See: https://www.childrenssociety.org.uk/sites/default/files/the_good_childhood_summary_2018.pdf (accessed 5 April 2019).

The Key. (2017) State of education survey report 2017. See https://view.joomag.com/state-of-education-report-2017/0676372001494577623 (accessed 5 April 2019).

Thierry KL, Bryant HL, Nobles SS, Norris KS. (2016) Two-year impact of a mindfulness-based program on preschoolers’ self-regulation and academic performance. Early Education and Development 27(6): 805-21.

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