Schools race for mental health protocols – 04/13/2023 – Daily life

The recent attacks on schools and the increase in apprehension among parents, students and educators in the face of threats of new attacks have caused a rush by public and private educational institutions in search of protocols and other mental health and violence prevention actions.

Companies that offer education consultancy and socio-emotional programs have seen, in recent days, the demand for assistance explode. Just last Monday (10), the consultancy Vozes da Educação was contacted by ten education networks and five private schools in search of protocols —in 2022, it supported four state networks and, until the beginning of this month, one.

The LIV (Life Intelligence Laboratory) program, which is currently in 500 schools across the country, received more than 30 new requests for assistance in three days, a number ten times greater than “normal” days. In the schools he already attends, he has been hosting circles about the fear generated by the attack.

At the same time, the Chamber of Deputies and the Senate this week announced public hearings to discuss the creation of teams of psychologists and social workers in public education networks and the sources of payment. The federal government instituted an interministerial group for the prevention of school violence.

The initiatives take place in the midst of an absence of public policies to face the escalation of mental suffering and violence in the school environment, a situation that was already perceived before the pandemic, which worsened after the health crisis and which has worsened even more in recent days. after the wave of attacks.

A 2022 report by an external committee of the Chamber of Deputies listed several gaps in the Ministry of Education’s performance regarding the issue of mental health in schools, including the lack of diagnosis on the mental health situation of Brazilian teachers and students.

The document shows that, due to lack of supervision by the MEC (Ministry of Education), a 2019 law, which deals with the performance of psychologists and social workers in schools, has made little progress. Only 6.5% of the 137,828 public basic education schools in the country have psychologists and only 3.7% have social workers.

The subject is complex and is far from being solved only with the offer of these professionals. A 2021 report by Vozes da Educação, in partnership with the Lemann Foundation, mapped 23 good mental health practices in schools in eight countries and points out that most of these initiatives do not involve clinical care, but referral to health and social professionals. social assistance.

According to lawyer and professor Carolina de Oliveira Campos, executive director of Vozes da Educação, the psychologist should not have the role of providing therapy in the school environment. “He is there to identify cases and refer them to a support network. The school is not an island. If it is a public school, we are talking about Caps [centros de atenção psicossocial]for example.”

The involvement of existing support networks appears as a proposal in another report that the Cactus Institute and Ieps (Institute of Studies for Health Policies) delivered to representatives of the Executive and Legislative with the recommendation of ten actions for mental health policies at Schools.

“There is the role of the APS [atenção primária à saúde]with nurses, social workers, community health agents, who can engage and take this care to adolescents”, says Luciana Barrancos, executive director of Cactus, a philanthropic entity that works to promote mental health.

According to Carolina Campos, successful initiatives, including in Brazil, have something in common: mental health referral protocols in emergency and non-emergency cases.

“The boy cut himself in the bathroom, he’s bleeding, but he was saying the whole time that his life is worthless. He’s losing weight, he doesn’t talk to his friends, he doesn’t brush his teeth to go to school, he’s isolated at recess . Oops! Look at all the signs I’m seeing here!”

But, according to her, having a paper with these guidelines is not enough. “I need to train educators to work with these protocols, create a support network, a multidisciplinary team to make this referral. And all this with a record and with the family aware. Tomorrow or the day after something happens, and the school will be called in the processes .”

The municipality of Joinville, in Santa Catarina, is one of those that has invested in this path. On the 5th, the date on which the attack on a daycare center in Blumenau (SC) took place, which left four children dead, the Department of Education launched a set of protocols to prevent school violence involving other departments, such as Health and Social assistance.

“The objective is to provide very clear guidelines on how to act and forward cases of threats, aggression, self-mutilation, or a child who is showing signs of atypical behavior”, explains the Secretary of Education, Diego Calegari.

The document deals, for example, with all types of violence (physical, psychological, sexual, institutional and heritage), bullying, racism, and what the school should do in each case. It also addresses how to record all actions in a detailed report, without issuing a personal opinion or value judgment.

“We cannot have each individual, at each moment, making arbitrary decisions about what to do when science already shows us what is most correct and what gives the most guarantee of effectiveness.”

For Luciana Barrancos, from Cactus, the country needs to take advantage of the urgency of this moment not only to “put out fires” but to build, in fact, a structure to promote mental health and prevent violence in the school environment.

She says that discussions on the subject were already taking place before the attacks, however, with the urgency of the moment, the search has been for immediate solutions. “But we know that mental health is multifactorial, it’s not a silver bullet, a recipe for cake that will address this. You have to look at the roots of the problem.”

In the opinion of clinical psychologist Renata Ishida, LIV’s pedagogical manager, there are several situations of violence happening at the same time, and society needs to organize itself to face them, and not just leave them in the hands of schools. “We need spaces for speaking and listening, to develop respect and coexistence with differences inside and outside schools.”

She claims that it is important to bring students to the forefront so that decisions are not made by adults alone. “We only really get involved in things when we understand that we are a constructive part of it. Students need to be together, thinking collaboratively.”

Unicef ​​estimates that the annual loss of human capital for the population between zero and 19 years old, due to issues related to mental health, represents a cost of US$ 340 billion worldwide. Anxiety represents 27% of the total cost, and depression, 22%. The loss caused by juvenile self-harm alone is in the order of US$ 47 billion per year.

According to Guilherme Polanczyk, head professor of child and adolescent psychiatry at Hospital das Clínicas at USP, recent attacks and the fake news generated from them have been an important factor in increasing anxiety and fear among children and adolescents. “I have patients reporting that they don’t want to go to school. If nothing is done, the cycle of violence and trauma will continue.”