News

02 December 2021
Volume 2 | British Journal of Child health · Issue 6

‘Toxic masculinity’ is stopping boys from seeking help for mental health difficulties

Fear of shame or feeling ‘weak’ is deterring young men from seeking help for mental health problems – and when they do ask for help, many are not getting it.

A survey involving 1 068 young men aged 14 to 21 (including 801 aged 14 to 18) found that 46% would not ask for help for a problem that was making them upset, anxious, or depressed – ‘even if things got really bad’.

When asked why, the research, which was conducted in October 2021, found that:

  • 36% said they didn't have the courage.
  • 32% said they ‘don't want to make a fuss’.
  • 30% said they would feel weak or ashamed.
  • 21% worried that people would laugh or think less of them.
  • 14% said they would ‘feel less 15% said they don't know how to ask for help.

The UK survey by youth mental health charity Stem4 also shows that many young men do not receive support when they ask for it.

Thirty-seven per cent said they were currently experiencing mental health difficulties. Of these, 51% had not spoken to anyone, 21% were receiving treatment, and 29% had asked for help but were not receiving treatment.

The most prevalent mental health difficulties reported in the survey were stress (47%), anxiety (27%), and depression or low mood (33%). Other common problems included eating disorders (11%), anger and behavioural issues (10%) and self-harm behaviours (9%).

When asked for ideas on positive steps schools and others could take to protect and improve the mental health of young people, the respondents suggested:

  • Regular mental health check-ups.
  • Safe places in which to ask for help.
  • One-on-one in-person treatment with therapists, not group sessions.
  • Better PSHE education in schools with practical guidance on how to ask for help.
  • Education for families on how to spot early signs of mental ill-health, and how to talk to their children.
  • Better, faster access to treatment.
  • Recognition that loneliness is real for boys and young men.

The research also asked the respondents which factors most affected their mental health and found that 46% identified ‘pressure from peers to behave in a dominant masculine way’ while 25% said being associated with peers who treat girls and women disrespectfully was another factor. Other causes identified were loneliness, bullying, and the pressure to look good or have a good body.

Comments from the boys in the survey included:

  • School pupil, 16, London: ‘Men aren't supposed to have emotions. Parents push toxic masculinity onto their children. It messes their head up later in life.’
  • School pupil, 15, East of England: ‘I had a suicide attempt and I got told to man up. If I was a girl, I would get so much more support.’
  • School pupil, 16, North East: ‘There is support, but it's difficult to talk about mental health issues when you get laughed at.’

Dr Nihara Krause, consultant clinical psychologist and CEO and founder of Stem4, said: ‘We live in a culture that puts huge pressure on boys and young men to behave in particular ways, many of them damaging to their mental health.

‘Our survey shows exactly why this is so damaging, with many suffering in silence, even when they're approaching crisis point.

‘If we're going to tackle boys and young men's mental health, we have to address the cultural blind-spots to male mental health. It's also time to start listening properly to boys and men, understand how they express their needs, and provide services that will benefit them.’

Stem4 is a charity working with young people, parents and schools and focusing on addressing commonly occurring mental health issues in teenagers including eating disorders, anxiety, depression, self-harm, and addiction.

Stem4 offers free access to four NHS-approved smartphone apps to help young people in the treatment of and recovery from mental health difficulties including managing anxiety, the urge to self-harm, and depression.

Further information and resources

  • Stem4: https://stem4.org.uk/

DfE promises final Climate Change Strategy by April 2022

A model science curriculum, a Climate Leaders Award for young people, increasing biodiversity in school grounds, and supporting schools to reduce carbon emissions.

These are just a few of the goals set out in the Department for Education's draft strategy for sustainability and climate change which was unveiled last week at COP 26 (DfE, 2021).

The strategy proposes to introduce ‘world-leading climate change education’ via the introduction of a model science curriculum at primary level by 2023 which it says will ‘teach children about nature and their impact on the world around them’.

It also pledges new CPD for science teachers focused on climate change and sustainability (by 2022) and free access to ‘high-quality curriculum resources’ (by 2023) for teachers of all phases and subjects.

The DfE says that the draft strategy is to be ‘built on over the next six months in collaboration with young people, educators, sustainability experts and environmentalists’. Final publication is scheduled for April 2022.

Elsewhere, the strategy introduces plans for a National Education Nature Park and Climate Leaders Awards (both by 2023).

The park initiative will encourage pupils to get involved in the natural world by increasing biodiversity in the grounds of their school via small steps such as installing bird-feeders.

The DfE states: ‘They will be able to upload their data onto a new, virtual National Education Nature Park – which will allow them to track their progress against other schools in the country, increase their knowledge of different species and develop skills in biodiversity mapping.’

It adds: ‘Combined, the grounds of schools, colleges, nurseries and universities in England take up an area over twice the size of Birmingham, so improving their biodiversity could have a significant impact on the environment.’

The Climate Leaders Award will recognise students' work to improve their environment with ‘a prestigious national awards ceremony held every year’. The DfE says students could progress through different levels of the award in a similar way to the Duke of Edinburgh Awards.

Elsewhere, the strategy focuses on the school estate and pledges that all new school buildings delivered by the DfE – but not including those already contracted – will be net zero in operation by 2023.

In terms of retrofitting existing school buildings, the strategy sets a 2025 target for evaluating ‘the best value for money approaches for retrofitting education buildings and developing standards for retrofit and repair to empower the education estate to make change’.

The DfE is also by 2023 to test new so-called ‘energy pods’ in schools. These are a low to zero carbon technological solution that offers heating and hot water to existing school settings via solar panels and technology to maximise their output. These could replace coal and oil heating systems.

School transport will be a focus too, with plans to ‘increase active and safe travel to school such as Bikeability, Walk to School Outreach and School Streets’.

And in terms of the school supply chain, the strategy proposes a review of school food standards by 2025 ‘to consider the impact of food emissions on the environment and whether more flexibility can be offered for schools to support local sustainability and provide more plant-based and meat-free options’. There will also be work and resources to support schools to reduce and manage food waste.

Response to the Sustainability & Climate Change draft strategy.

National Association of Head Teachers: ‘Many schools are already actively teaching pupils about the importance of conserving and protecting our planet through their existing curriculum. It's vital that any work on a new model curriculum is developed in close consultation with the profession and builds on the excellent work already taking place.’

National Education Union: ‘We welcome the notion of expanding the amount of climate education in the STEM curriculum but believe that this needs to be extended into wider areas of the curriculum such as religious education, economics, history, geography, and the arts – and we will want to engage further with DfE on this. It requires teacher training and curriculum space. Planning for all new school buildings to have zero emissions is welcome but we also need to look at retrofitting the current school estate.’

Further information and resources

  • DfE: Sustainability & Climate Change: A draft strategy for the education & children's services systems, November 2021: https://bit.ly/307SITM

Air pollution: Children demand the right to breathe clean air

With millions of UK pupils attending schools in high pollution areas, the right to breathe clean air looks set to be elevated by the United Nations Convention on the Rights of the Child

With air pollution set to become the leading cause of child mortality by 2050, the right to breathe clean air looks set to be elevated within the United Nations Convention on the Rights of the Child (UNCRC).

Access to clean air has recently been recognised as a human right but is not among children's rights as defined by the UNCRC.

It is estimated that hundreds of thousands of children a year die globally due to the impact of air pollution.

In the UK, research for Clean Air Day in June revealed that more than 3.4 million children go to schools in areas where air pollution levels are above World Health Organization (WHO) recommended limits.

And in September the WHO slashed its recommended air pollution limits in half in light of improved understanding about the impact on human health, meaning many more schools will now be situated in areas of concern for pollution.

Last month, the vice-chair of the Committee of the UNCRC, Philip D Jaffé, said he would be pushing for every child's right to clean air to be included in the upcoming General Comment 26.

General Comments are intended to provide ‘authoritative guidance’ to the governments of the 196 countries that have ratified the UNCRC and in June the Committee of the UNCRC agreed to publish a General Comment 26 focused on climate change-related issues.

It follows the work of the Freedom to Breathe coalition, which has been producing education resources and campaigning for the Committee of the UNCRC to act. Almost 30 000 children have added their voices to the campaign during the last six months.

A virtual campaign event on Wednesday (November 17) entitled A Child's Right to Clean Air heard testimonies from children across the world.

Appearing at the event, Mr Jaffé confirmed that his committee would be working to elevate the right to clean air within the UNCRC through the forthcoming General Comment 26. He said: ‘I will do my part and I will do everything I can with my colleagues to support you in what you are doing.’

The Committee of the UNCRC has already published a ‘concept note’ for the General Comment 26 (UN, 2021) which states: ‘It is reported that every year no less than 1.5 million under the age of five years die as a result of air pollution, water pollution, exposure to toxic substances, and other types of environmental harm.’

By 2050, UNICEF predicts that air pollution will become the leading cause of child mortality and the WHO estimates that in 2016 alone, 600 000 children died from acute lower respiratory infections caused by polluted air.

In the UK, the research published to coincide with Clean Air Day shows that 27% of UK schools – which equates to 7 852 nursery, primary, secondary and sixth form settings – are in high pollution areas. All but 160 of these schools are in England.

The research data measures concentrations of PM2.5 (particulate matter with a diameter of 2.5 microns or less). PM2.5 is formed of tiny particles that can cross from the lungs into the blood and then move around the body causing conditions such as heart and lung disease. They come from various sources including exhaust fumes, agricultural emissions, and dust from car brake pads and as such are common near busy roads.

The Clean Air Day research figures show the number of schools in high pollution areas using the old WHO recommendation of 10ug/m3. However, in September WHO slashed this recommendation in half, introducing a new pollution limit of 5ug/m3 based on the latest epidemiological studies showing the adverse health effects of exposure to high levels of air pollution. The evidence shows that even ‘countries with relatively clean air have reported adverse effects at much lower levels than had previously been studied’ (WHO, 2021).

The WHO's new guidelines also introduce updated levels for PM10, nitrogen dioxide, ozone, sulfur dioxide and carbon monoxide pollution.

The Freedom to Breathe campaign is run by Blueair, Global Action Plan, the Coalition for Clean Air, the Centre for Environment Education and Safekids Worldwide. A range of other organisations have also supported the campaign including UNICEF UK, Great Ormond Street Hospital (GOSH), and the Global Alliance on Health and Pollution.

Sonja Graham, CEO at Global Action Plan, which runs the UK's Clean Air Day campaign, said: ‘Change is more likely to happen now that we have the support of the Committee of the UNCRC so this acknowledgment is brilliant step in the right direction. Through the Freedom to Breathe campaign, the children came to recognise that clean air is an essential necessity for life – just like clean water and healthy food. We are thrilled that the UN is acknowledging this too.’

Further information and resources

  • For more on the Freedom to Breathe campaign, visit https://www.blueair.com/gb/freedomtobreathe.html and www.globalactionplan.org.uk/freedom-to-breathe
  • UN: General comment on children's rights and the environment with a special focus on climate change: Concept note, 2021: https://bit.ly/30z8OWo
  • WHO: New WHO Global Air Quality Guidelines aim to save millions of lives from air pollution, September 2021: https://bit.ly/3Hs7cyR

Bereavement: Resources to help support pupils

One in 29 pupils aged five to 16 have been bereaved of a parent or sibling – equating to at least one child in every average class.

Charity Barnardo's has published new resources for teachers to help them support children who are coping with bereavement.

The figure above is from before the Covid-19 pandemic. It is feared that many more children will now be affected by bereavement given that more than 165 000 people have died from Covid-19 in the UK.

Furthermore, Black people and men of Pakistani and Bangladeshi heritage are almost twice as likely to die from Covid-19 as White people, meaning children from these communities are more likely to experience loss.

The free resources about grief are available on the Barnardo's Education Community website. They include an introductory worksheet which explores what grief is and a volcano-making activity that focuses on how grief impacts us. They also include some suggestions and advice about how to cope and who children can talk to when going back to school after someone special has died.

Also in the resources are coping techniques for children to use when times are difficult, as well as exercises to help ground children and regulate their breathing. The resources were launched to coincide with this year's Children's Grief Awareness Week (November 18 to 24).

Barnardo's Interim Co-CEO Michelle Lee-Izu said: ‘Children have suffered a huge amount of loss in the last year. For most this has meant missing out on school and playing with their friends, but for too many children it has meant the loss of parents, grandparents and members of their family or community.

‘I hope that teachers who are discussing the issue of grief with their pupils during Children's Grief Awareness Week will find our tips and resources useful – and that they will be used to assist schools and colleges to support children who are struggling in the future.’

  • For details, visit www.educators-barnardos.org.uk

Research shows that one in five teachers are still ‘uncomfortable’ discussing LGBT+ topics

Eighteen years on from the repeal of Section 28 and one in five teachers say they still feel uncomfortable discussing LGBT+ topics with pupils.

Research from LGBT+ charity Just Like Us and involving 6 179 teachers asked them: ‘How comfortable do you feel discussing LGBT+ topics with your pupils?’

A third (29%) said they were ‘completely comfortable’, and half (52%) said they were ‘mostly comfortable’.

However, 14% said they were ‘not very comfortable’ and three per cent felt ‘completely uncomfortable’.

Primary phase teachers felt even less comfortable, with 19% saying they felt uncomfortable teaching LGBT+ topics and only 25% ‘completely comfortable’.

Dominic Arnall, chief executive of Just Like Us, said that he did not blame teachers: ‘We don't blame teachers for feeling uncomfortable – they may not have had the resources or personal life experiences – but all you need is a willingness to support your pupils.’

Just Like Us offers a range of free LGBT+ inclusive resources to primary and secondary schools, including lesson and assembly plans.

Section 28 existed from 1988 to 2003 and refers to Section 28 of the Local Government Act, which was enacted in May 1988 by the Conservative government.

It stopped councils and schools ‘promoting the teaching of the acceptability of homosexuality as a pretended family relationship’ (for more, see Day, 2019). It was repealed in Scotland in 2000 and England and Wales in 2003.

Speaking on November 18, Mr Arnall said: ‘Today marks 18 years since Section 28 was repealed in England yet clearly things have not changed as much as we like to think and, as a result, growing up LGBT+ is still unacceptably tough.’

Statutory relationships, sex and health education (RSHE) requires schools to teach LGBT+ issues. However, earlier this year Ofsted warned that there was ‘confusion’ in schools as to what to teach and when, blaming a lack of clarity in the guidance (Jones, 2021).

One middle leader told inspectors: ‘(The) guidance is too woolly – take it out or give us better guidance. (We need) greater clarity over what should be taught by when.’

The guidance does indeed leave a lot open to the discretion of schools. It stipulates that by the end of primary pupils should be taught ‘that others' families, either in school or in the wider world, sometimes look different from their family’. By the end of secondary, students should know ‘that there are different types of committed, stable relationships’ (DfE, 2019).

The guidance adds: ‘Schools should ensure that all of their teaching is sensitive and age-appropriate in approach and content. At the point at which schools consider it appropriate to teach their pupils about LGBT, they should ensure that this content is fully integrated into their programmes of study for this area of the curriculum rather than delivered as a standalone unit or lesson.

‘Schools are free to determine how they do this, and we expect all pupils to have been taught LGBT content at a timely point as part of this area of the curriculum.’

Previous research from Just Like Us has shown that LGBT+ young people are twice as likely to be bullied and have depression – an issue Mr Arnall discussed in a recent podcast on anti-bullying work in schools (SecEd, 2021).

Mr Arnall continued: ‘When so many teachers say they're uncomfortable discussing LGBT+ topics, such as mentioning that some families have lesbian mums, this has serious knock-on effects for LGBT+ young people's wellbeing and mental health. Having silence around LGBT+ topics only results in shame, stigma and students feeling that they don't belong in school.’

He added: ‘It is essential the government provide support and clear guidance for schools on supporting LGBT+ young people. We need to work together to improve the lives of LGBT+ young people so that young people don't leave school feeling ashamed or depressed about who they are.’

A view from the chalkface

One London teacher who took part in the Just Like Us research – who asked to remain anonymous – gave an insight into the barriers that still remain: ‘I have never felt very comfortable talking about LGBT+ inclusion in school because I've feared parents’ negative responses.

‘Many teachers I know share these concerns, however, I think that as a member of the LGBT+ community myself, these feelings are heightened because it is personal.’

This teacher says they are ‘lucky’ to work in a school ‘where I could be out to my colleagues’, but they have never come out to my students and very rarely come out to parents over fears of backlash.

They continued: ‘Where my straight colleagues could talk about their partners easily, even if it was a casual pronoun, this was something that I couldn't do.

‘There is an overwhelming false belief that to talk about LGBT+ people or families would be to talk about sex. In reality, being LGBT+ inclusive is actually most commonly about explaining that there are different types of families, such as gay dads, wellbeing and allyship.

‘The idea that we don't talk about any relationships with children is false. As early as nursery and reception, children hear about heterosexual relationships in books and play at being a heterosexual family in the home corner. They are constantly bombarded with cisgender, heterosexual people and pupils should be learning that LGBT+ people simply exist.’