A whole of school intervention for personality disorder and self-harm in youth: a pilot study of changes in teachers’ attitudes, knowledge and skills

Abstract

BackgroundThe school environment offers an ideal opportunity for early identification and intervention for youth with self-harm and complex mental health issues, such as borderline personality disorder (BPD). Yet, class teachers often report minimal knowledge, feeling ill-equipped to respond, and experience high levels of stress when exposed to such challenges. Research is required to understand how training and development activities led by school counsellors may enhance teacher attitudes, confidence and knowledge of self-harm and complex mental health issues, such as BPD. We aimed to explore the extent that a whole of school initiative might enhance capacity for early identification and intervention.Method18 secondary schools implemented a manualised program, Project Air Strategy for Schools. N = 400 class teachers (71.3% female, mean age 42 years) across city and rural locations were evaluated before and after program implementation on attitudes, knowledge and skills.ResultsProviding class teachers with additional training on complex mental health issues and associated behaviours such as self-harm was well received. Participants reported post-program improvements in their optimism (d = .35), confidence (d = .63), knowledge (d = .73) and skills (d = 0.67) in working with young people with complex mental health issues, such as BPD.ConclusionsProviding school counsellor led structured approaches, to help class teachers identify and respond to youth in distress, closed identified gaps. Results indicated improvements in class teachers’ knowledge and attitudes towards self-harm and BPD. The intervention also improved the capacity of schools to plan and implement strategies to reduce the impact of mental health problems on the young person and their peers. A stay-at-school psychological care approach was fostered by enhancing partnerships between class teachers and school counsellors.

Ideal standards for policy on student self-harm: What research and practice tells us

“…Post-training evaluation found that there was significant improvement in confidence, skill and knowledge of school staff towards self-harm, and that these improvements were sustained at a six-month follow-up. In 2018, the current authors collaboratively developed accredited training for teachers, and found that providing teachers with additional training on complex mental health issues and associated behaviours, such as self-harm, was well received (Townsend et al, 2018). Our results indicated improvements in class teachers' knowledge and attitudes towards self-harm and complex mental health issues.…”

“…Essentially though, self harm is any behaviour where a person intentionally sets out to harm themselves. – Wellsway School (2018, p. 2)One policy (Government of Western Australia, 2017) used the term ‘non-suicidal self-injury’. This policy emphasised that the aim of self-harm behaviours was to reduce or cope with distressing emotions, with no intent that this behaviour would result in death.…”

“…This policy emphasised that the aim of self-harm behaviours was to reduce or cope with distressing emotions, with no intent that this behaviour would result in death. Further, one policy (Wellsway School, 2018) emphasised the difficulty in providing a general definition of self-harm, arguing that the definition is individual and context specific.…”

Incidence, Severity and Responses to Reportable Student Self-Harm and Suicidal Behaviours in Schools: A One-Year Population-Based Study

“…However, where there is imminent risk, escalation to emergency services is necessary (Townsend, Hasleton, Marceau, Gray, & Grenyer, 2018b). Providing schools with structured responses can assist the capacity of schools to plan and implement strategies to support students (Townsend et al, 2018a).…”

“…School staff have a unique role in the detection and response to mental health issues, including self-harm and suicidal behaviours (Hasking et al, 2016;Townsend, Gray, Lancaster, & Grenyer, 2018a). In a survey of 15-19 year olds, 36% reported they would go to a teacher if they needed help while 30.4% reported they would turn to a school counsellor (Carlisle et al, 2019).…”