Mental health first aid in schools: A vital support system for students

This informal CPD article, ‘Mental health first aid in schools: A vital support system for students’, was provided by Dr. Mariana, EL HAJJ / Pediatrician and Health Programs developer at QIN Platform, who are passionate about transforming education and preparing students for the challenges of the 21st century. They provide innovative education solutions that integrate arts, STEM, health education, and sustainability seamlessly.

Introduction

The World Health Organization (WHO) defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.¹ Indeed, “there is no health without mental health”¹

In today’s fast-paced, often stressful world, schools are increasingly viewed as sanctuaries of growth and stability for young minds and not only places of learning. With the rising mental health concerns among students, the concept of "Mental Health First Aid" has emerged as an essential approach, empowering both educators and school nurses to respond immediately and empathetically to students facing challenges, creating a more supportive and safe school environment.²

Common mental health issues in schools and first aid approaches

The most encountered mental issues affecting students range from anxiety and depression, ADHD (Attention-Deficit/Hyperactivity Disorder), bullying and social stress, reaching self-harm, and suicidal thoughts. A significant number of students often manifest through physical symptoms—headaches, stomachaches, or fatigue. These symptoms might sometimes be the body’s way of expressing emotions that the student struggles to articulate, like sadness or fear.³ Rarely will a student openly say, “I’m feeling sad,” or “I need to talk.” It is up to teachers and school nurses to look beyond the surface of these physical complaints to uncover the true underlying issues.²

The classroom teacher serves a crucial role because it is the classroom teacher who alerts everyone to the problem; that child is not behaving normally.²

In this article, we will review the most common symptoms of these mental disorders and some helpful and actionable First Aid measures to help teachers and school nurses in their crucial roles.

Anxiety and depression

Restlessness and irritability, fatigue, withdrawal from friends, and loss of interest in once-enjoyable activities may be the first signs of anxiety and depression.⁴

First aid measures:

• A brief chat, with gentle curiosity and empathy, expressing support without pressing for details can make a significant difference.²
• Helping the student break down tasks into manageable steps, encouraging the focus on one thing at a time, is beneficial for calming down their worries.³
• Acknowledging their feelings and encouraging slow, deep mindful breathing can help in moments of overwhelm.⁴

Above all, listen with empathy, reassuring the student that their feelings are both valid and manageable, and always offer a pathway to speak with a counselor or mental health professional, emphasizing that support is always available.²

ADHD (Attention-Deficit/Hyperactivity Disorder)

ADHD challenges students’ ability to concentrate, often leading to impulsive behavior that disrupts classrooms.⁴

First aid measures:

• Setting clear, concise instructions can make a world of difference.⁴
• Using positive reinforcement for small achievements will build self-confidence.²
• Allowing them some flexibility to move if needed, as this can improve focus.⁴

Above all, redirect rather than discipline or punish to channel the student’s energy productively, reinforcing their strengths and fostering confidence.⁴

Bullying and social stress

Students who experience bullying or social stress often display signs of anxiety, withdrawal, and a reluctance to participate in group activities.³

First aid measures:

• Active listening, free of judgment, can create a profound sense of relief.⁴
• Offering a safe space to discuss their feelings and remind them that they’re not alone.⁴
• Helping students learn how to assertively express their feelings and boundaries when faced with bullying or uncomfortable situations, without resorting to aggression or passive responses.²
• Encouraging students to use "I" statements whenever they need to express themselves clearly; letting them benefit from the Powerful “I”s activity, e.g., “I feel upset when you …,” “I need you to stop …,” emphasizes their assertiveness by speaking firmly but calmly.³

Above all, promote resilience, and empower them with strategies to handle social challenges assertively by focusing on problem-solving skills.²

Self-Harm and Suicidal Thoughts

Adolescents may experience such extreme internal pain or anger that they attempt to harm themselves by cutting or undergoing excessive tattooing. Signs and symptoms of self-injury include the following: visible fresh, unexplained cuts or bruises, wearing long sleeves, even in very warm weather, and emotional instability with direct or indirect statements about self-harm.⁴

First aid measures:

• Calmly approaching and expressing genuine concern, ensuring the student feels safe and supported will show the students that they are not isolated.²
• Connecting them immediately with the school counsellor or mental health professional for further assessment and support is crucial.⁴

Above all, know your students and be alert; take any mention of self-harm seriously and inform and refer to a specialist immediately.⁴

Nonjudgmental empathetic listening, creating safe spaces and communications, sharing basic coping techniques, and ensuring referral pathways are the main mental health first aid measures in schools, and can play a vital role in early intervention and support, helping students develop resilience and emotional strength.

By equipping school staff with the skills to respond with empathy and practical solutions, we can foster an environment where students feel safe, understood, and ready to succeed.²

Conclusion

When students feel safe, supported, and understood, they can fully engage, grow, and thrive. However, if teachers were at least adequately trained, they might be more confident about how they manage the mental health issues of students in their classrooms.² Another crucial factor is the role that parents play in managing a child’s mental health, highlighting the importance of engaging the community.⁴ It is also important that school curricula take a holistic approach to, and keep a balance between, academic content and personal, social, and moral development.³

We hope this article was helpful. For more information from QIN Platform, please visit their CPD Member Directory page. Alternatively, you can go to the CPD Industry Hubs for more articles, courses and events relevant to your Continuing Professional Development requirements.

References

1. World Health Organization. (2021). Mental health in schools: A manual. World Health Organization Regional Office for the Eastern Mediterranean.

2. Gunawardena, A. H., McKibbin, K. K., & Phillips, J. L. (2024). Teachers as first responders: Classroom experiences and mental health training needs of Australian schoolteachers. BMC Public Health, 24(1), 268. https://doi.org/10.1186/s12889-023-17599-z

3. National Alliance on Mental Illness (NAMI). (n.d.). Mental health education in schools. Retrieved from https://www.namimn.org

4. Semchuk, J. C., McCullough, S. L., Lever, N. A., Gotham, H. J., Gonzalez, J. E., & Hoover, S. A. (2023). Educator-informed development of a mental health literacy course for school staff: Classroom well-being information and strategies for educators (Classroom WISE). International Journal of Environmental Research and Public Health, 20(1), 35. https://doi.org/10.3390/ijerph20010035