Lies, Damned Lies and Child Mental Health Statistics

For as long as I’ve been teaching there has been significant frustration about the availability of CAMHS – Child and Adolescent Mental Health Services – for those children and young people who urgently need help with mental health problems. In recent years the concerns have been magnified as people worried that the services were being cut even further as the population of young people tended to rise and I have no reason to doubt those claiming the services are inadequate.

However, in the last few months children’s mental health has been cited more and more in other contexts in the education debate. Want children to behave in school? That’s unfair, they probably have mental health problems. Want schools to be held to account for whether their students’ learn? That’s cruel, testing causes mental health problems. Think children are in school to learn? That’s selfish, schools should be dealing with their emotional well-being in order to prevent mental health problems. And that last point leads to calls to teach happiness, mindfulness and emotional literacy that schools buy into from time to time despite the huge questions over the ethics and efficacy of such lessons.

Worse, there have been claims that there is some kind of children’s mental health epidemic in schools. Not just a crisis caused by the lack of services, but actually a massive increase in mental health problems. Here are claims from some recent media reports (I have deliberately tried to avoid including stats that are based on subjective questions about whether problems are worse, or ones that are only about recent increases in specific conditions, so please be aware of the selectivity of my quotations).

Teenage mental-health crisis: Rates of depression have soared in past 25 years

How has society managed to produce a generation of teenagers in which mental-health problems are so prevalent?

…there is growing evidence that teens are in the grip of a mental-health crisis. It is as if, rather than acting out, young people are turning in on themselves.

Rates of depression and anxiety among teenagers have increased by 70 per cent in the past 25 years. The number of children and young people turning up in A&E with a psychiatric condition has more than doubled since 2009…

From The Independent February 2016.

Child mental health crisis ‘worse than suspected’
Natasha Devon, the government’s mental health champion in England and Wales, warns of ‘medicalising childhood’

…The crisis in children’s mental health is far worse than most people suspect and we are in danger of “medicalising childhood” by focussing on symptoms rather than causes, the government’s mental health champion for schools has warned.

Natasha Devon, who has been working in schools for almost a decade delivering mental health and wellbeing classes, said an average of three children in a class were diagnosed with a mental illness, but many more slipped under the radar.

…rates of depression and anxiety have increased by 70% in a generation,

From The Guardian, April 2016.

As children face a mental health crisis, should schools take the lead in fighting it?

There is a crisis affecting the mental health of England’s young people.

….Three children in every classroom have a diagnosable mental health condition. Half of these are conduct (behavioural) disorders, while one third are emotional disorders such as stress, anxiety and depression, which often becomes outwardly apparent through self-harm.

From The New Statesman, February 2016

Natasha Devon: ‘Britain’s child mental health crisis is spiralling out of control’

…It’s no coincidence that this generation of young people have seen a 70 per cent increase in mental illnesses, such as anxiety and depression

… a 2014 survey by mental health charity Young Minds found that children as young as 12 are concerned that they will be unemployed and cited this as a reason for their anxiety.

From the Telegraph, 29th April

Three children in every classroom have a diagnosable mental health condition.  …There has been a staggering 106 per cent increase in the number of children and young people presenting at A & E with a psychiatric condition since 2009. This much is clear: we are in the midst of a crisis regarding the mental health of our children.

From The Independent, February 2016

A closer look at these stories and others like seems to indicate that overwhelmingly the stories reference only a small number of sources. Usually there is a reference to Natasha Devon (and often to her charity the Self-Esteem team) or the charity Young Minds. Occasionally stories like this mention the charity Place2B set up by Camila Batmanghelidjh in the days before Kids Company. The statistics generally seem to be the ones on the Young Minds website. Of these, two seem to be repeated the most:

Among teenagers, rates of depression and anxiety have increased by 70% in the past 25 years, particularly since the mid 1980’s.

and:

The number of children and young people who have presented to A&E with a psychiatric condition have more than doubled since 2009. (8,358 in 10/11; 17,278 in 13/14)

The claim that about 3 children in every classroom having mental health problems (also made on the Young Minds website) is repeatedly mentioned.

None of these statements are false, when used in the correct context, but all three are misleading when used to describe a mental health crisis that is happening right now.

Dealing with each one in turn:

The figure about the 70% increase in depression and anxiety over 25 years has been widely quoted. The source appears to be a 2004 study based on a comparison of data from 1974, 1986 and 1999. Yes, that’s right, 17 years ago. It may or may not have changed since then, but it is clearly not evidence for a crisis now.

The figures about A&E come from a parliamentary answer which is worth quoting in full:

Luciana Berger Shadow Minister (Public Health): To ask the Secretary of State for Health, how many children and young people were diagnosed with a mental health problem in A&E in each year since 2009-10.
Norman Lamb The Minister of State, Department of Health:  The information is in the table:

Year	2009-10	2010-11	2011-12	2012-13	2013-14
A&E Attendances	8,358	9,328	11,614	13,655	17,278
FAEs	11,909	12,417	12,361	11,994	12,126

The table shows both the number of attendances in accident and emergency (A&E) in which the A&E diagnosis was ‘psychiatric conditions’ and the number of Finished Admission Episodes (FAEs) in which the primary diagnosis was ‘mental and behavioural disorders’.

This is a remarkable increase in attendances, but the FAEs, which as I understand it are the diagnoses that doctors gave show a completely different story. No significant change. Unless I’ve misunderstood the statistics, to quote only the first row without the second is, in my view, highly misleading. It shows young people attending A&E are more likely to be booked in as having mental and behavioural disorders, but the number being given that as a primary diagnosis is almost the same. Hardly evidence that the conditions are more common.

Finally, the three children in every classroom figure seems to date back to surveys from 2004. So once again the study seems less than up to date. Moreover, while I haven’t compared the methodology, I do recall reports that the rate for adults in surveys of mental health was 23%. Mental health is a very broad category, and half of people will have some kind of mental health problem in their lives, 3 children in every classroom is not that many, and without some indicator that their conditions are severe, that isn’t that many and is not a crisis.

As far as I can tell, there has been a long-term increase in the diagnosis of mental health problems over the last 50 years in young people (although I haven’t compared this with adult rates). Whether this is down to changes in diagnosis or in mental health I could not answer. But I can say that the idea that there is a “mental health crisis” in schools that has happened in the last few years seems to be lacking in good evidence from those who are claiming it is happening. By all means, let’s discuss the issue. Mental health is important. But let’s not be panicked by talk of “crisis” and let’s be very wary of the various vested interests who tell us they have answers to the problem. At the very least, let’s argue for long term investment in CAMHS, not gimmicks like happiness lessons or attempts to dumb down education to make it less stressful. Nor should we forget that, when asked, “Most children report high or very high personal well-being”.

My post for @LabourTeachers : Stop Demonising Academies

I wrote a post for Labour Teachers last week. As it was about education, I thought I’d share it here.

The government’s plan to make all schools convert to academy status over the next 6 years is an example of the sort of policy-making that gives politicians a bad name. It creates huge disruption and uncertainty without having any clear benefits.

But in the debate following the announcement, I have found myself frequently more annoyed by some of the critics of the plan than by the government. The reason for this is simple: I work for an academy. So do most secondary school teachers. And too much criticism of the plan has focused on the pretence that academies are evil. I don’t mind people pointing out that academies are not a magic bullet. I  don’t mind people pointing out the problems with accountability. I certainly don’t mind people pointing out the problem with the government’s plan. But enough with the sweeping generalisations about academies.

Two things have really annoyed me in the last few days. One was an infographic shared on Twitter (please note: this is not Jeremy Corbyn’s Twitter account).

I can sort of guess where some of the claims here are coming from. Others leave me baffled. But literally none of them are actually facts that describe all academies and no LA controlled school.

Then, this morning, I saw Labour’s shadow education secretary retweet a link to this story from the Independent website with the following headlines:

Academies are excluding ‘poor quality students’ – yet more social cleansing from the Conservative government

A recent report notes that academies “have developed behaviours that may have a negative long-term impact on society” as they “have become selective, do not teach their local community”

I was amazed to learn that: “we now have a move to deliberately exclude poor students from the best state education”. Apparently: “We must not allow academies to cleanse our nation’s schools of the students that feel they simply do not have time for”.

Now, some of this stuff would be at the very least highly debatable if it claimed to be talking about the average academy, or academies compared with LA schools or even the worst academies,. But in both cases the claims are made as if they apply to all academies, and at the very least they imply that what is described is normal for academies.

There is an irony here that the Labour Party and the left have been all too keen to accuse Tory politicians of “teacher bashing” and yet here we are where, in the name of ideological purity, we have people on the left describing thousands of schools, in fact a majority of secondary schools, and the hundreds of thousands of teachers who work in them, in terms that are so unjust as to be deceitful.

Academies are sometimes good, sometimes bad, just like LA schools. There are plenty of arguments to be had over how schools should be governed. But those arguments cannot be had sensibly if the starting point is that any claim can be made about the evils of academies, no matter how unfair it is to the people running them and the people working in them. Don’t tell me my school does not serve its local community. Don’t tell me that it is engaged in “social cleansing”. Don’t tell me it is run by a private company. Don’t tell me that my colleagues are unqualified. Don’t tell me that any of us care less about our students than we would if we worked in an LA school. None of this is true, and any campaign, any political point, based on these lies does not speak for me as a Labour member or as a teacher.

4 Things Sir Michael Wilshaw would never have said

Today, the Guardian reported that the hunt for Sir Michael Wilshaw’s replacement has reached its final stages. If the story is accurate, the shortlist is:

Amanda Spielman, the chair of exam regulator Ofqual and a senior figure at the Ark academy chain, is a frontrunner in a field that also includes Toby Salt, the chief executive of the Ormiston Academies Trust (OAT), Dame Alison Peacock, an experienced educator and primary school head, and Russell Hobby, the general secretary of the National Association of Head Teachers.

I have quite strong views on which one of these should get the job, but for once I’m going to keep them to myself in case I jinx it. But what really struck me is how different from Sir Michael Wilshaw all the candidates are. The following are all from interviews with, or writing by, the candidates. Can you imagine Wilshaw saying any of the following?

Amanda Spielman interviewed in Schools Week:

“I knit for pleasure,” she says. “It doesn’t require you to wrestle with abstract concepts, and because I’m a fidgety person, I find it very settling. In another universe, I would knit in a lot of meetings as I find it easier to pay attention to what people are saying.”

Toby Salt, mentioned in a story in the Independent about children choosing their own headteacher:

Toby Salt, the college’s deputy chief executive, says: “It’s vital that the pupil’s perspective is heard in appointing the leader of their school but, of course, the final word rests with the governing body. This is not about turning headship appointments into an X-factor style audition, but input from students can be a valuable addition to the decision-making process.”

Alison Peacock, in an interview published by the ATL:

The school often goes to unusual lengths to help children who are struggling. When one boy, with a very difficult home life, was going round threatening other pupils and shouting at teachers, a teaching assistant working with him discovered that his mother bred guinea pigs, and the school invested in some and made him the keeper of the guinea pigs. “He was very kind to the guinea pigs and so he went from being someone scary in a hood to being the guinea pig-stroker,” explains Alison. “You can’t get those things from a toolkit. It’s about being creative, having empathy, being prepared to do something different, taking risks.”

Russell Hobby, in a blogpost that has since disappeared from the NAHT website:

There is evidence coming in, for example, that demand in the workplace for “routine cognitive skills” – based on easily digestible knowledge (like lists of kings and queens) – is in decline, as these tasks are automated and outsourced. Of course knowledge matters, but the future lies in problem solving and interpersonal skills. Unfortunately our testing regime is strongly biased towards knowledge that is easy to measure; not necessarily the skills that our children will need to make sense of the modern world…

They used to say that generals always prepared to fight the last war. Thanks to our assessment regime and fantasies of traditional teaching, we may be educating our children for the last century.

Or perhaps I’m wrong and actually Sir Michael Wilshaw does say this sort of thing all the time. I’ll buy a pint for anyone who can find a picture of him knitting.

Or stroking a guinea pig.

Update 23/4/2016: Picture from @jamestheo added.

A quick note on the TES teacher blogger of the year award

I do my best to help promote education bloggers. For this reason, I tend to be more positive about blogging awards than most. Recently, I did my best to encourage nominations for the TES award for teacher bloggers. I then took it all back when I saw from her Twitter feed that shortlisting was being done by Natasha Devon, who had a history of being insulting to bloggers in tweets and blogs and who appeared to have no understanding or familiarity with teacher blogs beyond being offended by them. The sense that the awards were not taking blogging seriously was made worse by a nomination process that involved uploading 3 articles from blogs, as if the judges would not even be bothering to browse through the blogs that were nominated.

The editor of the TES then jumped in to say that actually there was another shortlister, and although they weren’t named, the implication was that they might know what they are doing. And sure enough, the final shortlist of 8 does indeed consist of 4 blogs that I cannot imagine Natasha Devon choosing, and 4 blogs which I can imagine her choosing. And I’d probably just leave it there, but I can’t resist pointing out what happens when somebody who is unfamiliar with blogging is given this sort of responsibility. At least one of the shortlisters failed to notice that some of the nominations don’t seem to comply with the entry guidelines.

The entry guidelines state the following:

• These awards celebrate achievements during the 2014-2015 academic year and are open to all state and independent primary and secondary schools in the UK

• We will accept submissions based on projects, initiatives or endeavours that commenced prior to the 2014-2015 academic year, provided that core achievements have taken place during this main period of focus. We will also accept any evidence that has come to light after the close of the 2014-2015 academic year if this further underlines success

And yet, when I look at the list of bloggers nominated I see that there is one blogger whose blog has no posts from before October 2015, and another whose only “blog” I can find is actually made up of unsyndicated articles on the TES website with no posts from before January 2016.

Of course, these bloggers may have been active somewhere else, (I think one of them had a site that is now defunct that was around from May 2015) but it does seem a little odd that anyone could be nominated as the best teacher blogger for their achievements in the 2014-2015 academic year, and even I cannot find a regular blog with any posts dated from that period. Could it possibly be the case that there was a shortlister who doesn’t understand how blogs work?

Update 15/4/2016: I’ve now heard from a couple of nominees that this year they are expected to pay £180 just to attend. Last year we were, as you’d expect, invited to attend for free. I do hope this is a mistake as this would make the whole thing seem like an utter rip-off.

@Ed_Dorrell @blagona pic.twitter.com/25SFEox1wE

— Miss Smith (@HeyMissSmith) April 15, 2016

Update 15/4/2016 but slightly later: In a not altogether surprising turn of events, and following a few hours of Twitter ridicule, the TES have now said that this was all a misunderstanding and the nominated bloggers will go for free.

Congratulations, to you all, and have fun.

 

Denying the debate about progressive and traditional education (Part 3)

I wrote a couple of posts previously here and here about claims that there was no debate between progressive and traditional education. I hope the second one was particularly useful, in that it pointed out disagreements that were clearly happening in schools right now, and how they were part of the debate about progressive and traditional education. Nobody actually tried claiming that those debates weren’t happening, though a few people seemed to think that I was wrong to frame the debates in that way. None actually seemed to identify an alternative framing.

I was going to leave it there, but I’ve started to notice that the ideology of progressive education is often at its most influential when it is not stated explicitly as a belief. It is at its most influential when it is simply assumed to be true that traditional classroom teaching is not as good. A lot of the time this is shown by people’s choice of lessons, resources or practice to share or publicise. When was the last time you heard somebody say “I’m going to be observed, I’d better make sure I give my best explanation and use my best textbook”? When was the last Teach Meet where there were more talks about giving a good explanation than about using technology? When was the last time anybody at an interview said “I became a teacher because I’m good at explaining my subject?”.

But it also goes the other way. People will talk about a lesson without obviously progressive elements as if they are embarrassed by it, or it was deficient. Here are two examples.

In this blogpost, a teacher describes how they dealt with a class with poor behaviour:

The rest of the lessons that week were much better. I went for zero tolerance on poor behaviour and set my expectations to the class very clearly. The structure of the lessons were very traditional – chalk and talk – and the pupils were expected to work on their questions individually.

Were these lessons successful? On some levels YES. I was able to spend lots of time helping and encouraging all my pupils. There was a lot of progress made with their algebra skills and there was a much calmer atmosphere in the class.

Here’s my problem – the lessons were boring and not overly engaging. I don’t like teaching classes this way. I want pupils to have discussions, work together, investigate and enjoy their lessons. But do the pupils learn more when working independently in peace and quiet?

Here’s where I need help – how can I teach the type of lessons I know my pupils need without letting the minority take over? If I can’t figure it out I worry that these pupils, who behave and want to learn, will get discouraged and not enjoy learning maths.

Here’s an example from this podcast featuring Vic Goddard:

You know, I know that I teach maths in quite a dull way. You know I haven’t progressed in my maths teaching, because it hasn’t been a priority if I’m honest, and I know that I go in and I demonstrate on the board; I show an example; you do a worked example; they have a couple of goes on their own, and they may have an exercise to do. That’s what they do; that’s what I do, and actually I’m actually probably quite scared to do anything else because it will take me longer to prepare. It will take me longer to get organized and, actually, have I got the time? And I need to be empowered as well and force myself to go: “well if I taught it in a different way, it would save me time in the long run and they’d understand it better”.

In these examples we have teachers talking about secondary maths lessons in which the teacher explains the maths and sets work. In both cases, they mention clear advantages to this approach. But the assumption is in both cases is that they would, ideally, be doing something different. Of course all lessons can be improved. Perhaps better explanations can be given, perhaps other elements could be added here and there, maybe some AfL, but here the teachers suggest that understanding and enjoyment require something different. Yet there’s no shortage of evidence that teacher explanations and worked examples can be really effective (some good references for this can be found here). It’s not something any teacher should be ashamed of doing, or even doing every lesson.

Obviously, it could be claimed that such examples are unusual. But they certainly chime with my experience of educational discourse. OFSTED may claim that they no longer require less teacher talk and compulsory group work, but plenty of teachers still assume that there is something wrong with chalk and talk. There’s a passage from Keynes that, in recent years, traditionalists in education have often quoted:

“Practical men who believe themselves to be quite exempt from any intellectual influence, are usually the slaves of some defunct economist. Madmen in authority, who hear voices in the air, are distilling their frenzy from some academic scribbler of a few years back”

Sometimes the influence of progressive education is there without us even being aware of it. Those who explicitly deny the debate in education are one thing, but perhaps, more worrying, is the extent to which teachers assume the progressives were right without even realising there is a debate to be had. This can happen even when they are teaching traditionally, and even when it seems to be working. We’ll know things have changed in education when a lesson where you explain something and set work is considered something to be proud of, rather than something to confess and apologise for.