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Early Detection Of Psychological Disorders

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information contained therein. 

PROJECT NUMBER:
Project No : 2023-1-DE03-KA220-SCH-000161162

 

Recognizing Early Signs of Mental Health Deterioration

What is Mental Health?

The World Health Organization (WHO) defines mental health as:
“Mental health is a state of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn well and work well, and contribute to their community. It has intrinsic and instrumental value and is integral to our well-being”

At any one time, a diverse set of individual, family, community and structural factors may combine to protect or undermine mental health. Although most people are resilient, people who are exposed to adverse circumstances – including poverty, violence, disability and inequality – are at higher risk of developing a mental health condition.”

Mental health is not just the absence of discomfort, but a sense of mental well-being.

Recognizing Early Signs of Mental Health Deterioration

Adolescence is an exciting time full of physical, psychological and social changes. These changes open the door to new ways of understanding the world and can sometimes lead to feelings of uncertainty or confusion. But it is also a unique opportunity! It is the perfect time to develop skills that will help you face life's challenges and fully enjoy each day. One of the most powerful tools you can cultivate is emotional intelligence - the ability to recognise, understand and manage your emotions, as well as empathise with others. By strengthening this skill, you will be better prepared to face adversity and take advantage of all the positive things this stage has to offer.

Why is it so important to talk about mental health in adolescence?

During adolescence, it is normal to experience changes due to this stage of transformation and the environment in which we live. However, there are certain changes in behaviour that could be signs that we, or someone close to us, are not going through the best of times. Identifying these signs early is key to seeking support and improvement. Pay attention to these important areas.

 

How do we identify our own or others' mental distress?

Mood

Changes in mood are natural in adolescence, due to the new contexts and hormonal adjustments of this stage. However, when these changes are very intense or prolonged, they may signal a maladaptive problem that deserves attention. Not all emotional ups and downs are worrisome, but if a negative mood persists or interferes with well-being, it is important to reflect on its cause and act.

A consistently sad mood or a lack of positive response to events that usually bring joy may indicate an underlying problem. Identifying these signs early and working on emotional management not only helps to overcome difficulties but also strengthens an adolescent's emotional well-being and resilience.

Behaviour

Changes in behaviour are characteristic of adolescence, as this stage involves adapting to new contexts and challenges. However, it is important to assess whether these changes are abrupt, maladaptive or whether the adolescent has difficulties in finding appropriate alternatives to cope with them. It should be considered that many changes in routine may be due to the search for new experiences, friendships or even fear of unfamiliar scenarios. It is therefore essential to investigate the context in which these changes occur to understand their origin and meaning.

It is essential to remember that these behaviours do not come out of the blue; they are often the manifestation of an underlying problem. The focus should not only be on the behaviour itself, but also on understanding and addressing the root causes. Detecting and working on these roots will enable the adolescent to develop healthier and more constructive responses to the challenges he or she faces.

Thinking and information processing

Our mental health is deeply intertwined with the way we perceive and interpret the world around us. Even when exposed to the same circumstances, individuals process information differently, shaping their emotions, reactions, and overall psychological well-being. These cognitive interpretations influence our ability to cope with challenges, make decisions, and maintain emotional balance. In many cases, distorted thinking patterns can negatively impact our mental health, reinforcing stress, anxiety, and maladaptive behaviors. Developing awareness of these cognitive distortions is essential for fostering more balanced and adaptive thought processes.

Some of the most common distorted thoughts are:

●       Overgeneralisation: using an isolated case (or few cases) to generalise a valid conclusion for all aspects of something.

●       Polarised view: seeing things in extreme terms, leading to impulsive and unwise decisions.

●       Personalisation: taking responsibility for something beyond one's control.

●       Catastrophic thinking: the tendency to overthink, of all possible scenarios, the worst one, even unrealistically.

●       Filtering: when there is a tendency to focus on the negative aspects of a situation and ignore the positive ones.

●       Thought-reading: believing that one knows the motivations and attitudes of others with little evidence of this.

Social relationships

Social relationships in adolescence are a key indicator of mental well-being, reflecting emotional stability, self-esteem, and psychological health. A sudden withdrawal from family, close friends, or social activities without a clear reason may signal emotional distress, disconnection, or internal struggles that require attention. Such changes can indicate feelings of loneliness, anxiety, or even early signs of depression.

Bullying, whether experienced as a victim or enacted as an aggressor, has a profound impact on self-esteem and emotional health. Victims may suffer from anxiety, low self-worth, and social withdrawal, while aggressors may also exhibit underlying emotional issues that require intervention. Both roles in bullying dynamics highlight emotional difficulties that should not be overlooked.

Social media platforms like Facebook, Instagram, and TikTok further shape adolescent social interactions. While they can facilitate connection, excessive use or a strong reliance on online validation can contribute to anxiety, unhealthy comparisons, and emotional dependence. Constant exposure to curated online personas may distort self-perception and intensify insecurities.

Additionally, a heightened need for peer acceptance can lead adolescents to engage in risky behaviors or compromise their personal values to fit in. This pressure to conform can increase emotional distress and negatively impact decision-making. Recognizing these shifts in behavior, understanding their root causes, and providing appropriate support are crucial in fostering emotional resilience and mental well-being.

Substance use

Substance use can be both a cause and a consequence of certain mental problems. Adolescence brings with it a reinterpretation of the ‘social self’. Problems of self-esteem and social pressure can lead adolescents to seek new intense experiences and expose themselves to dangers, trying to appear mature by taking risks and copying a very stereotypical adult lifestyle. That is why it is important to show them alternative leisure activities that are also exciting for them and allow them to develop in a healthy way.

Drugs can affect health from the earliest stages of drug use, without the need for prolonged or intensive use. This impact is particularly significant during adolescence, when the brain is going through a crucial phase of development and maturation.
Both legal drugs (alcohol and tobacco) and illegal drugs (marijuana, cocaine or ecstasy) are present in youth recreational settings. All of these substances can have significant effects on physical and mental health, affecting areas such as learning, memory and emotional control.

Other behaviours

The most explicit manifestation that something is wrong in an adolescent's mind is the direct expression of feelings of discomfort, such as negative comments about their own existence (e.g. ‘I wish I had never been born’ or ‘There is no solution for me’). However, there are also more subtle signs that may indicate emotional problems. These range from mild neglect of personal image and hygiene to more alarming behaviours, such as seeking to self-harm.

Self-harm often manifests itself in a variety of ways, including hitting hard surfaces (such as a wall) with the fist or head, or using solid objects. It is also common for some adolescents to resort to cutting accessible areas with the dominant hand. In some cases, circular marks, indicative of having extinguished a cigarette, may appear on the skin. Other self-harming behaviours, although less serious, are still of concern, such as compulsive scratching to the point of damaging the skin or the loss of strands of hair due to repeated pulling. These signs, although varying in intensity, require appropriate attention and support.

 

Myths around mental health

There are several myths and misconceptions about mental health that are important to address to better understand this reality.  To begin with, there is a widespread belief that people with mental illness are violent or dangerous, when evidence shows that they are no more prone to violence than the general population. In fact, they are often more vulnerable and more susceptible to harm from others.

Another common misunderstanding is the idea that people with mental health problems cannot adapt to society. The reality is that they can coexist and integrate well into the community, making valuable contributions according to their specific needs and abilities. It is essential to understand that many mental health problems are not permanent and can evolve favourably.

There is also a mistaken belief that mental disorders cannot be cured. This idea stems from a simplistic view that labels people as ‘crazy’, without understanding the complexity of mental health. Most mental problems are modifiable or adaptive, as they are influenced by context and can therefore improve or even disappear with appropriate treatment.

It is common to think ‘it can't happen to me’, but the reality is that anyone can develop mental health problems due to biological or contextual factors beyond our control. Statistics indicate that one in four people will experience some form of mental disorder in their lifetime, although fortunately there are ways to prevent and reduce risk factors.

When it comes to suicide, it is important to disprove the idea that ‘those who say they are going to commit suicide do not commit suicide’ or vice versa. Most people who attempt suicide communicate their intentions in advance to their social environment. Although these manifestations may sometimes have an instrumental component, this does not mean that the person is not experiencing profound psychological distress that requires attention and support.

Finally, when it comes to suicide, there is a myth that it is completely unpredictable and uncontrollable. While it is true that suicide has multiple causes and not all variables can be controlled, those close to the person can offer valuable emotional support, if only by listening and/or facilitating contact with professionals. Related to this, there is a taboo against talking about suicide, but this silence only makes it more difficult to understand the problem and the person's suffering, aggravating the stress and limiting the alternatives to alleviate their discomfort.

Let’s see an example

At 16, Adrián’s parents began noticing changes in his behavior. Once an enthusiastic and social boy, he started withdrawing from family and friends. He spent more time alone in his room, avoided conversations, and lost interest in activities he once loved, like playing football or video games.

His mood also shifted—he became highly self-critical, often saying things like “I’m useless” or “Nobody cares about me.” Small setbacks felt overwhelming, and he interpreted neutral situations as personal failures. His sleep and eating habits became irregular, and he stopped making plans with friends.

The real alarm came when his mother found a note with phrases like “Nothing will ever get better” and “I wish I could disappear.” Realizing this was more than just sadness, his parents approached him gently, encouraging him to talk and seek professional help.

Now it is your turn! How many symptons can you count? Which kind of distorted thoughts can you identify? Who can identify this symptons other than the family?

 

Communicating Concerns Effectively

When someone is experiencing psychological distress, an empathetic conversation can be a crucial first step towards recovery. The simple act of listening without judgement and showing genuine presence conveys a powerful message: no one is alone in their suffering.
This initial dialogue can not only ease the immediate emotional burden but also encourage the person to seek the professional support they may need. Here you have some tips for talking between adults and minors.

The importance of listening

●       Paying attention: reacting positively to their attempts at emotional connection, showing availability and interest, and listening actively.

●       Demonstrating affection and respect: expressing positive emotions towards your child through compliments, praise and positive comments; creating rituals that have symbolic and emotional meaning for you.

●       Building shared meanings: building trust and stability in your relationship through understanding and empathy; creating rituals that have symbolic and emotional meaning for you.

●       Enabling your child to achieve his or her goals: knowing and accepting your child's dreams; empowering your child's autonomy and self-efficacy.
Accepting their ideas and influence: listening to and accepting their ideas and opinions, even if you disagree; being open to their persuasion, even if it doesn't mean giving in to everything

●       Mutual acceptance: accepting them for who they are and not for the person you wish they were

Key points in a conversation with an adolescent

●       Compromise: showing flexibility in your decisions; reaching agreements that satisfy you both.

●       Gentle disagreement: learning to communicate a complaint or disagreement in an assertive way; not being critical or disqualifying.

●       Repairing communication: de-escalating your negative emotions during discussions with your teenager; interrupting the conversation if you think you may lose control and resuming more calmly afterwards.

●       Talking about difficult topics: being open to talk about sexuality, alcohol and drugs, mental health, divorce, death, etc.

Difficult to communicate and how to avoid it

In communicating with people experiencing emotional difficulties, it is common to adopt attitudes that, while well-intentioned, can be counterproductive. The tendency to minimise problems, to offer immediate solutions or to judge the situation may make the person feel misunderstood and close themselves off from sharing their experiences. It is therefore important to explore more effective forms of communication that facilitate accompaniment and emotional support.

Here is a list of attitudes that we tend to take impulsively, and we offer you a much healthier alternative:

●       Being hypercritical -> not attacking their way of being, not labelling; pointing out your disagreement with specific facts or behaviours.

●       ‘Talking to the wall’ -> not being mentally absent during conversations with your child; using active listening techniques.

●       Constant interruptions -> letting your child finish without cutting him/her off; not offering advice or solutions in a rushed manner

●       High rigidity -> reasoning and negotiating with the adolescent; not constantly telling him/her what to do, letting him/her decide for him/herself

●       Being defensive -> not counter-arguing against their complaints (‘mine is worse’); not counter-attacking against offensive comments and/or disqualifications your teenager makes to you.

●       Derogatory comments -> not insulting or humiliating them, even if we are annoyed; taking care of our non-verbal communication.

●       Stay quiet -> informing them of issues important to them or the family; addressing concerns your child may have and offering reliable information

●       Denial of difficulties -> not minimising your child's discomfort, accompanying and observing him/her; seeking advice or expert help in case of no improvement or worsening.

Remember! We are not trying to express our feelings, we are trying to understand the adolescent’s context and modify his/her behaviour. The adolescent has to see us as allies and he/she has to understand that the change is something positive.

 

Engaging the family

To strengthen students' mental health, the relationship between parents and teachers must be built on a deep understanding of each family's strengths. Every household has unique resources, experiences, and skills that can contribute to the student's well-being, making it essential for educators to recognize and value these aspects. Based on this understanding, family engagement strategies can be designed to not only address each family's specific needs but also enhance their strengths. This involves creating open and flexible communication spaces, adapting interactions to each household's circumstances, and providing opportunities for collaboration that allow parents to engage in their child's education using their own skills and knowledge.

Both parents and schools play a crucial role in preventing mental health problems by fostering healthy habits and supportive environments. Key areas of focus should include ensuring proper sleep and nutrition, encouraging regular physical activity, and promoting healthy social interactions. Establishing consistent bedtime routines, limiting screen time before sleep, and encouraging balanced meals rich in essential nutrients can significantly impact students' emotional and cognitive well-being. Likewise, physical exercise should be integrated into daily life, whether through organized sports, active play, or simply walking to school. Beyond physical health, fostering positive social relationships by teaching respectful communication and conflict resolution skills helps create a supportive community where students feel valued and understood.

Another essential aspect of prevention is the promotion of socio-emotional skills such as empathy, self-regulation, and resilience. Schools and families can nurture empathy by encouraging children to recognize and validate others' emotions, for example, through storytelling exercises where they imagine different perspectives. Self-regulation can be developed by teaching mindfulness techniques, such as deep breathing or reflective pauses before reacting in emotionally charged situations. Resilience, on the other hand, can be strengthened by normalizing failure as part of the learning process and encouraging students to view challenges as opportunities for growth rather than as obstacles. When children develop these skills, they are better equipped to manage stress, build healthy relationships, and adapt to difficulties.

It is equally important for adults to maintain a physically and mentally healthy lifestyle, both to have the psychological resources to support children's emotional needs and to serve as role models. Children learn by observing their parents and teachers, so when they see the adults around them managing stress constructively, maintaining healthy routines, and fostering positive relationships, they are more likely to adopt similar behaviors. Educators and caregivers should prioritize self-care, engage in hobbies that bring them joy, seek emotional support when needed, and maintain a balanced approach to work and personal life. By doing so, they not only enhance their own well-being but also create a healthier and more emotionally stable environment for children to thrive.

Asking for help

The first to detect a possible problem in an adolescent are usually the people in his or her closest circle: parents, teachers or friends. However, it is likely that they do not have all the necessary information or certainty about what is really going on in the adolescent's mind. Therefore, communication between the social environment, the school and the family is essential. Depending on the problem, it can be managed within these social agents, but in some cases it is essential to resort to the intervention of a professional.

How to know if professional help is needed?

The distinction between a mental problem and a mental disorder is crucial. A mental problem refers to temporary psychological difficulties caused by stress or life events, such as anxiety before an exam or sadness after a breakup. These issues usually resolve with time or support. In contrast, a mental disorder is a clinically diagnosed condition that persistently affects emotions, behavior, and daily life, such as depression or anxiety disorders. While mental problems can be distressing, they do not necessarily indicate a disorder. The key differences lie in their duration, severity, and impact on overall functioning.

Mental health difficulties can vary greatly in intensity, and while mild problems do not always require professional intervention, psychological therapy can be beneficial for anyone. Many people, however, struggle to distinguish the severity of a situation and may not fully understand what therapy involves. This uncertainty can sometimes delay necessary intervention. Recognizing when to seek professional support is essential for promoting well-being and preventing more serious difficulties from developing. To help determine whether psychological assistance is needed, consider the following guidelines.

When personal resources are insufficient: If an issue persists despite attempts to resolve it using common coping strategies or available support networks, seeking professional guidance is highly recommended. In particular, if an adolescent's behavior continues to raise concern despite efforts from family, teachers, or peers, a psychologist can provide the necessary tools to address the situation effectively.

When in doubt, prioritize intervention: If you are uncertain about whether professional help is necessary, it is always advisable to consult a specialist. Reaching out to a psychologist preemptively, even in cases that may not seem urgent, can provide valuable insights and prevent the problem from escalating. On the other hand, postponing help in a critical situation can lead to more serious emotional or behavioral consequences. Seeking guidance early ensures that individuals receive the support they need at the right time.

Communication between school and families is a fundamental pillar for the educational and emotional development of students. However, not all interactions generate the desired positive impact. To strengthen collaboration with families, it is essential that education staff adopt assertive, clear and empathetic communication strategies. Whenever possible, it is advisable that these interactions be led by a school psychologist or educational psychologist to ensure effective and sensitive communication. The following are key points for establishing effective dialogue with parents and caregivers.

 

How to talk with the family

How to talk with the family: What to DO

●       Establish rapport 

●       Explain the rules of confidentiality

●       Sit at the level of the informant; thus, if the student is a young child, sitting at the same level as the child is important

●       Use open-ended questions Do follow the lead of the informant

●       Use your active listening skills

●       For children, do use toys, props, or games to help them feel at ease

●       Use illustrations or examples with children to help clarify a question

●       Respect the informant’s defense mechanisms (i.e., silence or “I don’t want to answer that question”)

How to talk with the family: What NOT to DO

●       Do not ask questions you already know the answer to

●       Limit the use of “wh” questions (e.g., What, why, when)

●       Do not expect children under the age of 6 to distinguish time of events

●       Do not use psychological jargon

●       Do not ask yes/no or closed-ended questions

●       Do not make judgments on answers

●       Do not ask “why” questions to ascertain motives

●       Do not repeat the same question if a “silent” response is received

●       Do not confront the informant

Confidentiality and Sensitivity

Confidentiality in the educational and youth mental health context is a fundamental pillar that sustains trust between students, parents and educational professionals. It is defined as a commitment to keeping sensitive information shared by the student private, establishing a safe space where young people can express their concerns and seek help without fear that this information will be disclosed without their consent. This principle is especially relevant when dealing with adolescents, who are at a crucial stage of developing autonomy and need to feel respected in their decisions and confidences.

It is important to understand that concerns about confidentiality can significantly affect students' help-seeking behaviour. Young people are more likely to share their problems and seek support when they are confident that their conversations will be treated with discretion. However, many students experience fear or uncertainty about what information will be shared with their parents or teachers, which may lead them to hide important problems or avoid seeking professional help altogether when they need it.

Clear and ongoing communication about the limits of confidentiality is essential in the educational environment. Students need to understand from the outset what information can be kept private and in what situations professionals are obliged to share information with parents or authorities, especially in cases involving risk of harm. This transparency helps build trust and allows young people to make informed decisions about what information to share and with whom, thus fostering their autonomy and personal responsibility.

Managing confidentiality requires a delicate balance between respecting student privacy and keeping parents informed about their children's well-being. Educational professionals must develop clear protocols for determining what information is essential to share with parents and how to do so in a way that does not compromise student trust. It is critical to recognise that the ability to make decisions about the privacy of their information is not necessarily tied to a specific age, but may vary according to each student's individual maturity and experiences.

Breaches of confidentiality can have serious consequences for the relationship of trust between the student and educational professionals. When students discover that their information has been shared without their consent or prior knowledge, they may develop ‘selective storytelling’ strategies or stop sharing important information altogether. Therefore, it is crucial that any need to share information is discussed in advance with the student, explaining the reasons and seeking their understanding and cooperation in the process. This respectful approach helps to maintain the integrity of the supportive relationship while ensuring the safety and well-being of the student.

 

Actions and Referrals

Identifying adolescents who may be experiencing mental health problems is crucial for early intervention and the prevention of long-term consequences. Mental health issues are complex and multifactorial, influenced by a wide range of factors that can be categorized into two main groups: risk factors, which increase vulnerability to developing a mental disorder; and protective factors, which strengthen resilience and promote well-being. For a comprehensive and effective approach to mental health, it is essential to focus on identifying and mitigating risk factors while actively fostering protective factors. Importantly, many of these factors are shared across different mental disorders, emphasizing the need for a holistic perspective on mental health promotion.

Risk & Protective Factors

While some risk and protective factors are beyond our control - such as genetic predisposition to certain conditions -, it remains crucial to acknowledge their presence and pay close attention to the adolescent’s behavior. At the same time, we can strengthen those aspects that are within our reach. For instance, while we cannot change an individual’s genetic vulnerability, we can encourage physical activity, which is a key protective factor for maintaining both physical and mental health. By understanding these influences, we can better support adolescents in building resilience and navigating challenges, ultimately fostering their overall well-being. Below, we present a list of risk and protective factors to help identify potential areas for intervention and support.

Risk Factors

●       Low self-esteem

●       Anxiety

●       Poor social skills (e.g. shyness)

●       Extreme need for approval

●       Emotional problems in childhood

●       Positive attitude towards drugs

●       Poor parenting

●       Marital conflict and family conflict

●       Parents with mental health problems

●       Peer rejection, loneliness

●       Poor academic commitment

●       School/community/family violence

●       Traumatic event

●       Overly permissive or authoritarian families

Protective Factors

●       Positive physical development

●       Academic development

●       High self-esteem

●       Emotional self-regulation

●       Good coping skills

●       Family provides structure

●       Supportive relationships with family

●       Clear expectations for behavior and values

●       Presence of mentors

●       Support for development of skills and interests

●       Opportunities for engagement within school and community

Levels of prevention

It is not necessary for teachers to determine whether a child has a mental disorder, nor to diagnose a child with a mental disorder. Attempting to diagnose children risks inappropriately labelling a child, alienating children and their parents, and requires specialized training. Rather, it is important for teachers to understand how to support the mental health of all students in the classroom, including those with mental health problems and disorders, and to determine when mental health problems are severe enough to require additional help from family members and/or a mental health specialist.

Behavioural management strategies for schools

Discipline is a key part of school life, ensuring a structured and respectful environment. Various strategies are used to manage behavior, but it is crucial to prioritize methods that support students’ development. Negative discipline techniques, such as corporal punishment, harsh criticism, or threats, should never be used, as they can increase aggression, lower self-esteem, and negatively impact emotional well-being. Instead, positive discipline techniques are far more effective in promoting good behavior. Setting clear expectations, reinforcing positive actions, and applying fair consequences encourage students to develop self-regulation and respect for others. A supportive approach not only improves behavior but also fosters a safe and motivating learning atmosphere, helping students grow both academically and emotionally.

Tips to manage disruptive behaviours

●       The most effective approach is to focus on prevention by establishing a structured classroom routine that reduces opportunities for misbehavior.

●       Setting clear, reasonable, and consistent boundaries is essential, as unpredictable or constantly changing rules can lead to confusion and frustration.

●       In some cases, ignoring minor inappropriate behaviors may be effective, but only when they do not involve harm to the child, others, or property. It is important to note that initially, ignoring may cause an increase in the behavior as the child seeks attention before it eventually decreases.

●       When possible, redirecting or distracting the student can be a useful strategy. For instance, if a student begins to disrupt the class, engaging them by asking a question, having them read aloud, or involving another student in the discussion can shift their focus and discourage further misbehavior.

●       Let children experience natural consequences of their actions when safe to do so, as this teaches valuable lessons. For instance, if a child is mean to a classmate who then avoids them, discuss the situation instead of forcing interaction. This helps them understand the impact of their behavior and motivates them to find better ways to interact.

●       Guide students in developing decision-making skills by offering simple choices and discussing how their decisions affect both themselves and others.

●       When disruptive behavior occurs, teach alternative responses such as engaging in productive tasks, taking short breaks to regroup within the classroom, or helping with other activities in the building. If a student becomes too upset, allow them time and space to calm down before rejoining activities.

●       Work collaboratively with students to establish detailed waiting procedures, such as counting to ten followed by raising their hand and making eye contact with the teacher.

●       Focus on teaching and reinforcing constructive behaviors including sharing, negotiating, and working together with peers.

●       To facilitate smooth transitions between activities, implement a countdown system where you announce remaining time at regular intervals, such as every minute for the last five minutes.

●       Make a conscious effort to provide specific praise throughout the day, recognizing students' accomplishments and positive behaviors. Pay particular attention to acknowledging when they successfully regulate their emotions after experiencing disruption, and ensure they receive positive reinforcement for appropriate conduct. This targeted praise helps reinforce desired behaviors and creates a supportive learning environment.

●       When facing resistance to instructions, reframe the situation around student choice and consequences. For example, explain that choosing not to complete work now means either additional homework or staying after school.

●       Establish clear boundaries regarding aggressive behavior at the start of the academic year, when students are receptive and calm. Set explicit expectations about personal space (like maintaining specific distances in line), communication etiquette (waiting for others to finish speaking), physical boundaries (keeping hands to oneself), and respectful interaction with peers. These guidelines should be communicated clearly and specifically, with concrete examples that students can easily understand and follow.
Importantly, maintain consistency, predictability, and fairness in your disciplinary approach to ensure students understand and respect the established behavioral framework.

●       Educate students about anger management by helping them understand how anger develops and what specifically triggers their emotional responses. Guide them to express their feelings through words rather than aggressive actions.

●       When students show signs of frustration or opposition, begin by acknowledging their emotional state and validating their feelings - for instance, recognizing their disappointment when following correct steps still leads to incorrect answers. Then, guide them toward constructive alternatives by presenting choices. For example, offer them the option to either attempt a new problem using the same method or revisit the current problem together, carefully examining each step to identify where the error occurred. This approach combines emotional awareness with practical problem-solving strategies.

●       Implement time-outs as a behavioral management strategy by temporarily removing students from challenging situations, with duration typically matching their age in minutes.

●       Recognize and reinforce positive behavior by communicating successes to parents through encouraging notes sent home. When correction is necessary, maintain a composed demeanor, delivering reprimands without displaying anger or hostility.

●       Foster a sense of community and collective responsibility by using inclusive language when giving instructions - for example, emphasizing group membership with phrases like "we need" and "we can." This approach helps students feel part of a larger community while following directions.

When to refer to a specialist

●       When behaviours/symptoms are getting worse rather than better.

●       When behaviours/symptoms are negatively impacting the child’s functioning at home or at school.

●       When symptoms are severe or distressing.

●       When there is risk or danger towards self or others.

●       When classroom interventions in the classroom alone are not enough.

In case of doubt, ask for a professional evaluation!

Cognitive-Behavioural Therapy (CBT)

When an adolescent attends psychological therapy, it is common for the practitioner to use Cognitive Behavioural Therapy (CBT). This evidence-based approach has the most scientific support for addressing a wide range of psychological difficulties, including anxiety, depression, obsessive-compulsive disorder, and behavioural problems. CBT combines strategies from both the cognitive and behavioural models, as its name suggests. The cognitive model focuses on how individuals process and interpret information from their environment. It helps adolescents identify and challenge maladaptive or irrational thoughts that contribute to emotional distress. By learning to reframe these thoughts, they can develop healthier perspectives and improve their emotional well-being.

The behavioural model, on the other hand, emphasizes modifying behavioural patterns through structured techniques such as exposure therapy, reinforcement strategies, and behavioural activation. These methods help adolescents replace unhelpful habits with more adaptive coping mechanisms.

By integrating both cognitive and behavioural strategies, CBT provides adolescents with practical tools to manage emotions, develop problem-solving skills, and build resilience. Research consistently shows that this approach is highly effective in treating various disorders, making it one of the most recommended therapies for young people struggling with emotional and behavioural challenges.

In some cases, the psychologist may recommend involving a psychiatrist, a medical doctor specializing in mental health. Psychiatrists are the only professionals who can prescribe medication, which should always be complemented by psychological therapy. Effective communication between the psychologist and psychiatrist ensures comprehensive, coordinated care tailored to the adolescent's needs.

When seeking help, you may encounter individuals promoting unscientific methods based on pseudo-therapies or mystical beliefs. It is essential to verify a practitioner's credentials, including their academic degree and registration number, to ensure proper training and regulation. Additionally, the therapist’s style and personality influence the therapeutic relationship. If the adolescent does not feel comfortable with a professional, do not be discouraged—finding the right therapist is key to effective treatment.

 

Creating a Supportive Environment

Primary prevention in a school setting focuses on the everyday environment that shapes students' experiences and well-being. This includes the role of educational staff, the physical and organizational structure of the school, daily schedules, and the activities carried out within the institution. All these factors play a crucial role in fostering a supportive atmosphere that contributes to the mental health of adolescents.

By creating an environment that prioritizes inclusion, emotional well-being, and positive interactions, schools can help prevent mental health issues before they arise. We will explore key recommendations that schools can implement to cultivate a nurturing and psychologically safe space for students, ensuring that the school setting itself becomes a protective factor in their development.

Skills of a good teacher

●       Understands different developmental stages of the adolescent, setting age-appropriate tasks

●       Is empathetic: recognizes feelings and reflects these back to students

●       Is attuned to both the verbal and non-verbal communications of students

●       Communicates effectively and clearly

●       Makes student behavioural expectations clear and establishes limits that benefit and provide useful structure for the student

●       Arranges the physical and interpersonal environment of the classroom in such a way to optimize teaching and minimize disruptive behaviour

Caring for all

Creating a caring and inclusive environment requires intentional actions that make students feel valued. Recognizing and celebrating each student’s unique talents fosters self-esteem and a sense of belonging. Equally important is ensuring fairness and inclusion, where no student faces discrimination, and all are treated with respect and support. A culture of understanding must be nurtured, where students facing difficulties are seen as needing help rather than as a burden. Additionally, a clear mechanism for handling complaints is essential, providing students with a trusted process to voice concerns. By reinforcing these principles, educators can cultivate a safe, supportive environment where all students feel empowered, respected, and secure in their community.

Valuing diversity

Encouraging students to appreciate diversity—whether in ethnicity, religion, or disability status—enhances education by fostering understanding and mutual respect. Teachers play a crucial role in shaping positive attitudes toward children with special needs, helping other students recognize how to support and interact with peers who may seem different. For instance, a student assisting a classmate in a wheelchair promotes empathy and inclusion.
Practical strategies to encourage diversity include implementing a buddy system, which fosters friendships and support networks. Integrating students with special educational needs into mainstream classrooms benefits all students by improving social skills and empathy. Additionally, encouraging students to take pride in their backgrounds, heritage, and culture during school activities helps create an inclusive environment where diversity is celebrated.

Building self-esteem

Schools play a fundamental role in students’ self-esteem, and staff have a substantial impact on how students see themselves and how they are shaped for the future. Being in situations where they consistently experience failure at school usually has a detrimental impact on self-esteem in students. Similarly, when students have success at school, when they correct their mistakes, when staff have them do tasks (even “chores”) that show confidence in the student, it builds self-esteem.

When students know that staff understand how they felt about something or why an action seemed to make sense, they develop greater self-esteem (e.g. “Yes, I can see how it made sense at that moment to just scream back at that person, it was scary; how do you feel that worked out?”)

For older students:
- Assign responsibilities and leadership roles, such as organizing field trips or rotating classroom chores.
- Prioritize praise over reprimands, aiming for five positive comments for every negative one.
- Encourage cooperation instead of competition, recognizing teamwork and peer support.
- Allow older students to mentor younger ones, helping them with reading or social interactions.

For younger students:
- Create activities that help them showcase their skills and build confidence.
- Make a “I Am Special” or “Things I Am Good At” book to highlight their strengths and share with the group.
- Do the “My Hand” activity, where children trace their hands and write a positive trait on each finger.
- Use scripted role plays or puppets to help them navigate emotions like sadness, anger, or worry.
- Make bead bracelets where each bead represents something they like about themselves, then discuss their meaning with the group.

Building relationships

Good relationships between students and teachers, as well as among students, are crucial for emotional development, fostering trust and responsibility. Strong relationships are linked to better cognitive and emotional outcomes, while poor relationships can lead to depression and absenteeism for both students and teachers. Identifying each student’s strengths helps them feel valued. Teachers model positive relationships, and when these are collaborative, students are more likely to adopt similar behaviors. Parental involvement is key to student success, higher attendance, and a positive school climate. Effective communication with parents, modeled with respect, helps create consistency between school and home, reinforcing skills learned in both environments.

Ensuring safety

It is crucial for children to feel physically and emotionally safe at school, especially for those with disabilities. Aggressive behavior, even if not directed at vulnerable students, can lead to withdrawal.

To ensure safety, schools should implement a policy addressing bullying and disruptive behaviors, including cyberbullying. Teach students how to respond to bullying, whether as victims or bystanders, using developmentally appropriate strategies. Younger students can report bullying to adults, while older students may need guidance on how to handle it without fear of social backlash, such as by ignoring, walking away, or seeking help from another adult.

Any threatening behavior must be addressed immediately. Teachers and staff should be approachable, with clear guidelines on how to listen, gather information, and take action to resolve issues swiftly.

Encouraging participation

The most effective schools foster a positive atmosphere built on community and shared values. Student participation is enhanced when school leaders actively consult with students and parents about school matters. Students are more likely to follow rules they helped create.

To improve participation:

●       Involve students in school decisions, such as through councils or voting on policies.

●       Encourage parental involvement by sharing not only challenges but also students’ successes.

●       Showcase students' work throughout the school and highlight their contributions, such as improving the school environment or organizing activities.

Fostering independence

An important role of schools is to empower students to become independent. Learning becomes more effective when students are encouraged to think for themselves, as it helps them develop critical thinking skills. The most significant factor influencing academic achievement is the student's ability to monitor and assess their own work, determining how to further develop and apply their skills. In this process, constructive teacher feedback plays a key role, as it helps students gain the independence and responsibility needed to take control of their own learning.

To promote independence:

●       Assign age-appropriate responsibilities to students within the classroom and school.

●       Provide structured opportunities for students to give feedback and share their opinions.

Early identification and intervention

Identifying and addressing problems early can help prevent more serious mental health issues. Educators must balance the risk of labeling a child too soon with the benefits of early intervention. Their role is not to diagnose but to recognize difficulties, provide school support, and refer to specialists if a student’s condition worsens despite interventions. Schools should establish clear policies for early identification and intervention, ensuring a structured support system. Defining who teachers should contact, such as a principal or lead teacher, streamlines the process. Additionally, child study teams that regularly meet to discuss struggling students can improve early intervention efforts.

Support and training for staff

Working with children who have mental health issues can be challenging and stressful. Teacher workload and student behavior are key predictors of depression, and overwhelmed teachers struggle to support their students effectively. To prevent burnout, schools should encourage open discussions about classroom difficulties and establish teacher support groups for peer or professional consultation. Providing training in behavior management techniques can help teachers handle challenging situations. Schools should foster a positive environment that supports teachers' professional and personal growth while helping them reconnect with their passion for education. Additionally, teachers should be aware that difficult student behavior may mask deeper issues like domestic violence or family problems, making empathy and understanding essential in their approach.