Theme 2: Children’s mental health in educationYoung adults and children of all ages and ethnicities across the globe, are facing more and more mental health issues throughout their educational journey. Research conducted by the Mental Health Foundation (2019) depicts that more than 1 in 10 children aged 10-15, have no one to talk to or they would choose not to talk to someone if they were feeling troubled or miserable. The proportion of children diagnosed with a mental health issue is equally the same. Mental Health Foundation (2019) also analysed that 50% of mental health issues are found by the age of 14 and 75% are found by the age of 24. Another key fact established by the Mental Health Foundation (2019) portrays that young adults and children in the UK face extreme levels of anxiety and depression due to the societal pressure of succeeding, examinations and also body image. The National Health Services (NHS, 2018) conducted a survey on the mental health of children and young people in England. Key facts found from the survey gathered that one in eight (5 to 19 year-olds) had at least one mental health disorder when assessed in 2017, and most of these disorders were emotional disorders. Exam stress causes a bigger rise in mental health issues especially for children ages 12 to 18. The NSPCC (2018) reported that young people in the UK confided in counsellors, stating how the exam process is very overwhelming. The causes of feeling stressed and anxious stems from struggling with the workload and not feeling prepared enough for exams.As mentioned in Theme 1, countries like the UK have been consistent with using summative assessments to measure children’s knowledge. Many students become anxious from taking such examinations, this is called test anxiety. Test anxiety creates a feeling of nervousness, worry and fear of participating in something they are assessed in (Oxford Learning, 2018). Test anxiety causes a negative impact for children as it can prevent them from doing as well as they could, moreover test anxiety can occur in children at any age. It impacts a student academically as it also lowers their self-esteem, self-confidence and determination to do well. The causes of developing test anxiety sources from the pressure of completing a test within a certain amount of time, the intimidation of completing a test in a crowded classroom, a lack of understanding of the content could also cause test anxiety. Moreover, if the student has achieved a poor result from a previous test this could also affect their confidence. Mentally, a child could be scared of getting poor grades, which makes them overthink and underestimate their ability. There could also be a fear of letting other people down, such as their teachers or parents. They may have high expectations of their own performance, and from their results they could use this to reflect on their self-worth. Harlen and Crick (2002) define the impact to children’s mental health from summative assessment. Conditions such as self-efficacy is obstructed to the extent to which their determination is fundamentally affected, they may become less motivated or encouraged to do well or in other ways, it could motivate them to succeed. This sort of pressure is enforced by parents, teachers and adults outside of school. Psychologist, Albert Bandura (1994) defined self-efficacy as one’s beliefs of their own capabilities to produce a performance based on events and experiences that influenced their lives. If a child experiences only easy successes and achievements through the continuous use of summative assessment, they would be easily discouraged by failure. However, if a child has experienced many successes with failures throughout their education, they are least likely to be affected by these failures and it would encourage them to work harder and achieve their targets. Summative assessment tends to label a child immediately based on what they have achieved on that particular test/assessment. This is why it is important that teachers are aware of what this labelling does, it categorises children into groups based on what they seem to know. Therefore, formatively assessing children is as vital (Maddux & Stanley, 1986).Harlen and Crick (2002) also emphasises on collegiality, to define a constructive debate on the testing and use of assessments in school. They continue to portray the importance of teachers discussing the significance of assessments with their pupils, instead of focusing on the results of their performance. It has proven to be a positive change to children’s self-efficacy when collegiality occurs amongst teachers and students. Parents also play a great role in encouraging their children, however it can place a negative pressure on children giving them stress and anxiety and hindering their confidence (Schunk, 1989). For parents to be involved in their children’s education is essential for success. Their involvement leads to many positive outcomes, it serves a bigger purpose for their achievements, it helps to motivate and gives the child a stable environment at home in order to have a stable mindset at school (Menheere and Hooge, 2010). According to many researchers such as, Epstein (2001), Fan and Chen (2001), and Jeynes (2003), they have gathered data on parental involvement, clarifying it as a positive influence on not only the child but it also helps teachers and parents to create a great partnership on working collaboratively together to help the child grow. Epistein’s theoretical framework of parental involvement shows that all parents are different, their morals, upbringing and ways of teaching their children come in all forms. What the parents know reflects on the child’s understanding and knowledge of the world too, it is essential that parents are always communicating and participating in their child’s education for them to achieve good grades (Epistein, 2001). It is mentioned that although parenting styles come in all forms, they could also be overbearing and dominating in their child’s life, this could also create mental disorders (Fan and Chen, 2001). When parents create a pressured environment at home, sometimes the child may feel that what they are accomplishing in education is not enough for them. This relates to their self-efficacy once again, their motivation processes are being affected as someone that is important to them (a parental figure), may be telling them that they are not good enough. This leads to a hinderance for the child to think that they cannot do better in school. Sharma (2013) stressed on the common ideas of parents and grandparents in Asia, pushing their children to do their best in school. Children feel at competition with other children, it is a constant battle to be accepted into the most elite universities, colleges, and even international work companies. Due to the strict societal values of education in Asia, this creates more pressure on the children. Parents spend less time and money dedicated to other needs for children, such as basic health care. Sharma (2013) emphasises on how Chinese families cut back on household spending to focus on their children’s education. Families who have less income also value their child’s education as their priority. Therefore, it creates a bigger impact on how children think, they believe that there are no chances given to fail and that they must use every opportunity to improve on their grades. The effects of this belief can cause serious mental health issues for the child. The Annual Report on China’s education (2018) revealed that research into teenage and child suicides within the last five years were triggered by academic stress, especially the series of ongoing assessments, that society put on them including teachers, parents and friends. Findings from the annual report proclaim that the top three core motives for teenage suicides are commonly sourced from family conflicts (33%), academic stress (26%) and teacher to student conflicts (16%). The influential ideas of teachers, schools, families and society often create a greater impact on children’s self-efficacy, self-confidence, self-recognition, and emotional state of mind. It is essential that schools prioritise children’s mental health by mentoring them, assisting them with any difficulties or challenges and to develop coping methods they may find useful to reach personal targets (Epistein, 2001). Similarly, Weale (2017) an education correspondent, spoke on primary school children in the UK suffering from the stresses of national examinations such as SATs. A survey of school leaders gathered information on primary school children showing an increase level of stress and anxiety especially when they are going through an examination period, other mental health issues were also found in the survey which happened to be caused by assessments and tests (Weale, 2017). The educational framework that has been similarly duplicated in many frameworks globally, seem to have a recurring challenge of ensuring positive influences on children’s mental health. The series of national assessments used in schools from primary years up to university degrees, has proven to portray a negative impact to children and young adults’ emotional state of mind. Not only is having low self-efficacy levels an issue for children in today’s society, but also how society views assessments and examinations in schools are seen as a normal thing to have. It is almost unusual and bizarre, if a school promotes learning without having the use of summative assessment on their pupils. It is essential that practitioners are aware of the signs of mental health issues which may arise in students in order for early intervention to be taken as soon as possible. Schools must ensure they have suitable services for their students to approach to without feeling embarrassed or intimidated to ask for help (NHS, 2016). Students should be able to ask for help from a teacher, a friend, a nurse, or a family member. Many schools offer counselling services from professionals that are qualified to deal with mental health problems. There are also student-led services that offer help from other students, they are not qualified counsellors however, they are most likely to understand what another student may be going through, especially if it concerns exam stress (NHS, 2016).The Department of Health and Department for Education (2017) published a report called ‘Transforming Children and Young People’s Mental Health Provision: a Green Paper’ establishing the action that is already underway to transform children’s mental health services. It is stated that the government has already put out an additional £1.4 billion to build a programme to invest this into young children and adults’ mental health services. It is crucial for schools to ensure that they advertise the help that is offered to students by these services, so they are able to reach out and ask for help. More importantly, working in partnership with mental health services and schools is also critical, as it allows agencies to understand a child’s situation and what they may be going through, it is also easier to identify problems that need attention. Schools and colleges should accommodate broader action to help expand practice in principal areas such as, identifying and acknowledging to individual needs, advanced training for teachers to deal with mental health issues, and sessions on mental health with parents, carers and students. There are many unique mental health approach models set out to tackle and prevent any mental health issues, caused by personal problems. It is critical that children and young adults receive holistic support. The ‘Expert Working Group’ model portrays holistic support for mental health and well-being that a student should receive to feel enabled by their environment, resources, relationships and education (Social Care Institute for Excellence, 2017). Figure 1: Expert Working Group Model (Social Care Institute for Excellence, 2017). This model emphasizes on the perspective of a child’s thoughts on how they should be supported. Enablers such as, teachers, well-trained professionals, services and also family members to support a child through their education. Similarly, there is a three-tier stepped care model used in settings in Hong Kong, enhancing the critical roles needed to ensure a child’s education, medical needs, social opportunities and family needs are met. The three-tier stepped care model attached below portrays the first tier as universal prevention, early detection and intervention. It refers to services which aspire to avoid behavioural and emotional issues from existing or becoming a major setback for a child. Tier 2 of this model aims for intervention and assessment, it also connects Tier 1 and Tier 3 together. Lastly, Tier 3 promotes services and support from specialists that are best at moderating severe special needs cases. Hong Kong Special Administrative Region Government (2017), emphasised that there is inadequate support from services that are meant to specialize in education, social and family services. This results to children, teens and young adults from feeling mentally and physically stable. It is important that services in Tier 2 are improved in order for cases to not escalate to Tier 3 and the target would be to return these cases to Tier 1. Figure 2: Three-Tier Stepped Care Model (Hong Kong Special Administrative Region Government, 2017). ConclusionsThe exam culture in the UK education system has led to overbearing pressure that is placed on students to achieve high grades (Torrance, 2004). Government policies and legislation promote on awareness of schools ensuring their students are mentally stable and supported (Putwain, 2009). The research collated from multiple sources demonstrated the views summative and formative assessments used in schools in the UK and across the world. It has been made clear that both assessment types are as important as each other. There are advantages and disadvantages to both, therefore teachers must ensure that students get the opportunity to practice both assessment techniques. For example, presentations, debates, group discussions, pencil and paper examinations, observations are all different and they require multiple practice skills that would allow students to adapt to real-life situations. Research collected by NHS (2017) on children’s mental health caused by exam stress and test anxiety, portrays a rise in statistics, many of which become suicidal or their mental state becomes weaker developing different mental health issues. Moreover, there is also an increase in numbers in other countries such as China, Korea, and Hong Kong. Mental health problems are often a taboo subject in Asian countries because many have too much pride in admitting that they have a mental health issue, or they find it hard to believe themselves that they may need medical help (World Health Organisation, 2017).