The Columbine High School massacre has focused attention on identification and provision for children at risk.

Realistic observers can not help but observe that our youth culture has major problems. Many causes are blamed – television violence, the breakdown of the family, societal changes etc, and many reports, indeed gabfests, commissioned. Many an academic and professional career will be launched on the tragedy of Columbine.

An encouraging international trend is a recognition of the importance of early identification programmes for child mental health. The evidence in favour of early intervention is almost universal – the question is what form.

A Christchurch longitudinal study at the Christchurch School of Medicine (David Fergusson) has gathered data on 1275 children born in a four month period in 1977 and tracked the group since then. The study is acclaimed worldwide and is used to strongly advocate for early intervention. Says Fergusson “by age 7 or 8 you have enough information to make a prognosis.” Factors impacting on child mental health included social and economic disadvantage, impaired parenting, especially poor monitoring of children (the parents of the Columbine killers had absolutely no idea of their children’s demeanour or behaviour), inconsistent discipline, abuse, high levels of family conflict, high levels of mental disorder in parents, poor peer relationships and other individual factors. However, the study cautions against basing early intervention programmes based on any one factor. “Where the truth lies is not in the isolation of any one risk factor, but in the accumulation and patterning of risk factors.” The Christchurch study concluded that up to 15% of adolescents have mental health problems.

Patrick McGorry – Professor of Psychiatry at Melbourne University talks of a rising tide of mental disorders showing up in increased violence and youth suicide (New Zealand – highest in the world, Australia 4th). He sees the causes as being sociological and sociopolitical.

The adult world now is more competitive and less forgiving.
Jobs are more fluid and less accessible.
Families are less stable.
Communities are more urbanised and less subsistant.
There is higher material needs and pressures
Puberty is earlier

Mental disorders and disruptive anti-social behaviour have high instances of overlap. Some studies show depressive illness occurs in up to 7% of youths by age 15 and 15% by age 18 and depression can now be identified as the major predictor of youth suicide.

Some significant (but worrying) implications come from early intervention research. Professor Mark Fraser (University of North Carolina) observes a child who is aggressive at age 5 years, was equally or more likely to be aggressive at age 10 years and that poor school achievement at age 10 is a predictor of delinquency at later ages. He believes the combination of aggression and rejection by popular peers as the most “potent combination” (studies of serial killers would confirm this opinion).

Anne Williams – Adelaide Women & Children’s Hospital, also believes many warning signs appear in early childhood – “What you can measure at age one you can measure at age five.” Babies with insecure bonding often have relationship difficulties and peer problems later in life. (An interesting sideline to her research is that while maternal postnatal depression can cause behaviour and learning problems for boys, girls are immune. She speculates that girls many internalise feelings which later emerge as adolescent eating disorders and depression which effects more girls then boys).

A University of Queensland researcher, Margaret McFarland, studied detection of mental health problems in primary schools and found that because of the close and holistic nature of primary teaching, teachers were aware of potential at-risk children but for various reasons decide not to intervene (the process, the stress, the risk, the lack of resources).

David Fergusson agrees, “many children with problems are well recognised by their teachers, parents and peers by age 8. The problem is not so much in terms of recognition, but in a lack of response to the recognition.”

At Matipo School we articulate that we are a child centred school dedicated to children. We articulate that we advocate for children and that we cater to the whole child.

I concede that we haven’t catered to some of our children as well as we could have. We advocate strongly for our children in terms of resources, special needs, and some aspects of child protection and care. We try hard in the provision of a good quality balanced education. However, for other children we have been guilty of taking the easy option of doing nothing, of putting it in that too hard basket, for the reasons stated above – it’s too time consuming, too frustrating, there is a lack of responsive agencies, we buy a fight with parents and there is too much risk.

I would like to think that we could do better and make a more sincere commitment to our mission statement and to our children. We need to provide some compensatory intervention to children at risk of poor care, mental health disorders and varieties of emotive behaviour. We need to be aware of the warning signs:

Aggressive behaviour
Depression
Withdrawal
Poor peer relationships
Anti-social or deviant behaviour
Abuse
Family conflict/trauma
Socio-economic factors impacting on adequate care and hygiene
Effective parenting difficulties
Known parent factors – alcoholism, mental disorders

Where there is a combination of these factors or serious concern of one factor, the situation should be referred to the principal to investigate possible causes of action. Referral to Public Health Nurse and C.Y.P.S. are obvious options.

We are taking part in a pilot programme involving a social worker/counsellor internship with Unitech. The principal has access to funding and other sources for food, clothing and medical attention. I am going to establish a part time “field worker” position to work with a small group of “at risk” children (with care deprivation problems) and hopefully with their parents. The task will be to establish a rapport and trusting relationship with the children, to complete a needs analysis, to give the children reinforcement and security of their worth and to address basic caring issues. Hopefully, successful contact can be made with the parents to offer support and if necessary to put them in touch with supportive agencies.

At the same time our intern counsellor will work with cases referred on from our field worker or directly from the principal and if necessary cases will be referred on to outside agencies (see flow diagram).

The bottom line is that I intend to be more pro-active in trying to provide an early identification of children at risk and trying to do something about it. I have avoided the school being involved in child protection and social work provision but the harsh conclusion is that if we don’t do it, no one will, and we will have failed our children. Neither this school, nor society, can continue to look the other way.

Teacher Concern Parent Concern

Principal

Field Worker

Counsellor

Other Agencies*

* Other Agencies May Include: Public Health Nurse, Special Education Service, C.Y.P.F.S., Glenburn, Lawyer, Presbyterian Support.