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School students still hesitate to communicate about mental health, especially to adults

15The service of a psychologist at school are assessed positively, most students do not link a person‘s experience of a mental health challenge to a sign of weakness or personal failure, however, at the same time consulting with a psychologist remains a social stigma, the diagnostic analysis of youth mental health focusing mostly on the Lithuanian school context shows. The analysis is carried out by The Government’s Strategic Analysis Center’s Policy Lab.

Mental health stigma

Data gathered through administrative data, a survey of key stakeholders involved in mental health service delivery, and user-centered workshops revealed that there are still negative attitudes towards mental health and mental health disorders. Stress (79%), bullying (86%), anxiety (81%), social anxiety (79%), depression (76%), worrying (62%), and self-harm (60%) were indicated to be the main reasons for visiting the psychologist, however, most students have admitted that they would consult a psychologist only when they really need help. More than half of respondents have identified a belief that visiting a school psychologist can lead to bullying. While being asked to reflect on the other concerns regarding their visit to a psychologist, students also have mentioned the requirement of parental consent for in-depth counseling.

Students have predominantly associated psychologists with distrust, lack of confidentiality, ineffectiveness, or personal distance, and dissociation. Students have indicated relative hesitation when it comes to communicating about mental health and mental well-being themselves, especially to adults. 31% of students have reported talking to no one, and most students have indicated their preference of talking to peers rather than their parents or personnel (23% would never talk to parents and 31% would never talk to personnel). Experts recommend examining and finding school-based mental health interventions that aim to reduce the stigma of seeking help.

Towards active ecosystem collaboration

According to respondents, teachers and parents are crucial actors in monitoring and addressing student mental health challenges as they have extended, day-to-day ground-level contact with students. However, the cooperation between teachers, parents, and students is not always ensured. Parents are not very involved in school life; they lack motivation, especially when the feedback about their child is negative. School is often perceived as a so-called “youth territory”. Teachers often do not inform students about the communication with their parents. Experts recommend strengthening teachers' and parents’ knowledge on youth mental health.

“The analysis shows that among students there is a need for mental health services, but they would prefer new methods and forms of the knowledge design and delivery processes. Students have suggested real-life experience-based teaching, more interactive teaching style, unlimited time dedicated for discussions, educational applications, virtual consultations, less formalized space, or more unconventional arrangements, “Dalia Bagdžiūnaitė, the senior policy analyst at STRATA, says.

Authors of the analysis highlight the importance of greater involvement of top-level policymakers and more effective cross-institutional coordination. It is recommended to establish a cross-institutional coordinating body to ensure coherent collaboration across ecosystem actors and progress towards common goals.

„We have found that there are no common definitions of mental health topics, and this complicates dialogues on mental health issues, the formation, and coordination of preventive activities. It is necessary to develop a commonly understood set of definitions. At the same time, it is very important to define and standardize procedures related to young people's mental health, also to identify, adapt and expand good practices, “D. Bagdžiūnaitė tells.

Analysis findings also show that school in the entire youth mental health ecosystem is often perceived as a relatively autonomous unit; school is often viewed as a so-called “small kingdom” therefore a more cohesive integration of the schools into the ecosystem network is recommended. Also, experts recommend fostering research and experimentation on best practices for youth mental health services and strengthen the data collection and its systematic integration into the database.

The analysis is carried out by STRATA in collaboration with the Ministry of Health, Ministry of Education, Science and Sport, Ministry of Social Security and Labor; and the World Bank’s Bureaucracy Lab.