Supporting mental health at school

Between 70 – 80% of autistic children and adults experience or have experienced mental health difficulties.¹ It is a subject that impacts many people, yet the right support isn’t always there for individuals. This blog will outline some of the approaches and strategies that can be utilised in a school environment to ensure that autistic individuals feel supported when navigating their mental health and wellbeing.

If at all concerned about the mental health of a young person it is important that parents and families reach out to mental health services and professionals who will be able to help.

Autism and mental health

The Diagnostic and Statistical Manual of Mental Disorders (DSM5) 2013 highlights that autistic characteristics include the following:

• Persistent difficulties with social communication and social interaction
• Restricted and repetitive patterns of behaviours, activities or interests

A diagnosis of autism can often overshadow cooccurring conditions such as generalised anxiety disorder, obsessive compulsive disorder, depression and sleeping disorders. If all conditions aren’t addressed properly, this can impact upon individuals receiving adequate mental health support.

In addition to other diagnoses, a person’s early history can impact upon mental health, such as any adverse childhood experiences (ACEs) – below are some examples of what might constitute an ACE.

The long-term impact of ACEs continues to be studied. One of the current findings has been that ACEs can lead to an overactive stress response system.² This means that for autistic children and young adults, they might see something which we consider to be minor, such as running out of milk in the morning, as a major emergency. This may be reflected in the behaviours that challenge that emerge from interruptions to routine.

Proactively supporting mental health

There are several protective factors that can mitigate against ACEs – largely centred around building positive relationships with safe adults:

• Early experiences of being nurtured and positive relationships with adults can have a positive impact on behaviour and development. Children thrive when offered affection, listening, consistent expectations and safe opportunities.
• Mental health starts with the parents too. Parents with strong social networks often find it easier to support their child and care for themselves.
• Parents who know how to access essential services around childcare, mental health are better equipped to ensure the wellbeing of their child. Parents not knowing where to turn for information can often be a big barrier in their journey – our resource hub has a range of great resources to support parents upon receiving a diagnosis for their child.
• Parents who can deal with the stresses of everyday life have the flexibility and strength needed to bounce back against adversity.

Mental health and wellbeing strategies for use in schools

Teaching hierarchies

Regardless of need, the belief at BeyondAutism has always been that learners need to learn complex skills/coping strategies. We always look to support learners through their preferred method of communication giving them the tools they need to understand mental health and techniques to deal with their emotions.

We break down bigger topics such as bereavement into manageable steps, starting from ‘red’: essential skills and working up to ‘green’: more advanced skills (please see below as an example). When we break down skills into smaller steps, it allows all pupils, regardless of ability to have access to core skills and curriculum. As pupils master skills, introducing a differentiated curriculum can enable pupils to continue to be successful with more complex topics.

Visual stories

We use visual stories to support pupils with practical scenarios e.g. medical visits, going on holiday as well as more complex topics, for example the death of a family member or the breakdown in a relationship. Visual stories can support autistic learners in several ways, from overall understanding of complex topics to gaining a better understanding of routines and rules. For more advanced learners, it could allow them to reflect on how their behaviour might impact others or promote better self-awareness. Find out more about visual stories with our handy resource.

Zones of Regulation

Another really useful tool is Zones of Regulation. We have several check-ins throughout the day: registration; start of each group lesson; end of day reflection where learners can share how they are feeling. Pupils also have specific Zones of Regulation targets, in their individual education plans, to help support them with recognising emotions in themselves, others and suitable strategies to help them to regulate . We recognise that learners will not always be in the ‘green zone’ and we teach them that that is ok. One of the most beneficial tools from the Zones of Regulation framework is it allows pupils to start to understand their and others’ emotions and recognise how they can best support themselves and others at all times and through the full range of emotions.

Learner mental health debriefs

Debriefs can be a powerful tool to support a learner with their mental health and emotional wellbeing. We use a combination of symbols and Zones of Regulation to support learners in the aftermath of a mental health crisis. We use these for both the individual and anyone else who may have been affected e.g. if the individual shouted at or hit a peer:

• Visuals can be useful to support with debriefs as they can take a complex scenario and make it easier to digest. Pupils may also not be in the mood for talking about it (enough time should be given between the event and the debrief to ensure it doesn’t cause more anxiety for the individual)
• Explain what happened in the moment or give the pupil an opportunity to say what happened in their preferred communication method
• Explain how their friend was feeling in the moment if applicable
• Ask pupils how they are feeling
• Direct learners to their emotional regulation toolkits if they self-identified as feeling worried/scared and explain that they can speak to their safe adult.

Environmental factors

As well as physical factors, it is important to also look at emotional risk factors, and how we can best mitigate against those risks. Examples of triggers may be noise in the environment; being unsure about expectations and environmental changes (a new classroom, new teacher etc.). Strategies to mitigate these triggers may include acknowledging the pupils’ feelings and teaching around asking to leave appropriately.

Person-centred planning

It is therefore important to utilise person-centred planning, trauma informed care and practice when supporting autistic individuals.

PCPs are tools that allow an individual to input about the decisions that affect them. This can include voicing the things they like and dislike, their interests and motivations, how their ideal day would look and how they want others to communicate with them. PCPs are therefore crucial to an individual’s mental health and wellbeing and are especially valuable with assisting in managing transitions, planning for the future and overcoming new challenges.

Each PCP will differ from person to person so it is also important to consider an individual’s values, which could be.

• Being with friends
• Getting good grades
• Having fun
• Doing things by myself

There is plenty that can be done to support the mental health of autistic children and young adults and what we’ve outlined above barely scratches the surface. Take a look at our Lunch and Learn session on the topic to delve into some of the ideas in more depth. Or if you want to speak to us about how we do things, or how we can support you, get in touch today.

1. Ambitious About Autism (2017), Know Your Normal
2. Panksepp, J. (1998). Affective neuroscience: The foundations of human and animal emotions. Oxford University Press.