Lectures by Prof. Stanley Kutcher: May 2019

Mental Health a Priority in Adolescents

The Maltese Association of Psychiatry in collaboration with the Institute for Education invited Prof. Stanley Kutcher to discuss Mental Health Literacy and the Mental Health and High School Curriculum Guide. This evidence-based curriculum, produced by Prof. Kutcher himself, was initially implemented in Ontario, Canada and thereafter taken up by 13 other countries.

Prof. Kutcher is a Senator of Canada, Fellow of the Canadian Psychiatric Association, Fellow of the Canadian Academy of Health Sciences, Sun Life Financial Chair in Adolescent Mental Health and Former Director of WHO Collaborating Centre in Mental Health Policy. You can view his CV here for more information.

Apart from delivering the training to Educators, Prof. Kutcher was invited to give a Lecture to the General Public on 20 May 2019 at the Ministry of Education followed by a lecture for MAP members on 22 May 2019.

Mental health literacy has only been introduced by the World Health Organisation (WHO) in 1994 but physical health literacy has been taught in schools for over a century.  It is not enough to have mental health awareness. Teachers, students and parents need to have mental health literacy. 

Prof. Kutcher advocates the need to develop the capacity to differentiate between existential experiences and a mental disorder.  It is important to have stress in order to build resilience. Unfortunately, nowadays, we have taught our children that stress is bad for them leading to children who refuse to sit for exams and take frequent days off school. By avoiding stress, they do not challenge themselves and cannot reach their full potential.

As is known from basic physiology, cortisol rises in times of stress and this is a normal reaction. It is only abnormal, if the cortisol remains elevated for prolonged periods of time which is often the case with mental disorders. Hence, we must distinguish mental distress (which is normal) from mental disorders.

Prof. Kutcher reiterates that we have never in the history of humankind had it so well. We have good nutrition, clean water, shelter, antibiotics, the facilities to travel abroad (including exchange programmes), job opportunities, and yet, younger generations are incapable of dealing with stress. They are not given the skills to do so but rather, they are taught to avoid stress.

As a culture, we have developed “mental malaise” and this is further reinforced by the media, with words such as “crisis” or “epidemic”. The media describes skyrocketing rates of depression and anxiety but this is not evidence-based. Studies show that prevalence of mental disorders have remained the same. It is the self-reporting of perceived mental disorders which has increased.

Prof. Kutcher notes that while some schools feel they are helping children by accommodating for anxiety they are in fact disabling them. Most people experience some degree of stress before an exam which is a normal stress response; some do have an abnormal stress response and those are the children and adolescents who need help.

In the end, Prof. Kutcher insists that in order to be successful one has to experience and live with stress.  History is testimony to this. Martin Luther King and Ghandi brought about great change at the cost of their lives. They clearly did not avoid stress to do so. Success cannot be achieved if children are taught to avoid anything which can cause anxiety such as an exam or giving a public speech.

The Mental Health and High School Curriculum Guide was introduced for this purpose, to improve mental health literacy and help distinguish between mental distress and mental disorder.

Prof. Kutcher together with MAP Members

Dr. Emma Saliba, Psychiatry Trainee, was responsible for the implementation of the Guide in Malta. Teachers, child psychologists and counsellors underwent training aimed to:

  • Improve school based mental health literacy.
  • Provide teachers with the knowledge, competencies and capabilities needed to effectively address mental health of their students.
  • Comprehend how to obtain and maintain satisfactory mental health.
  • Understand mental disorders and their treatments.
  • Reduce stigma related to mental disorders.
  • Augment help-seeking efficacy.
  • Promote early identification and prevention of substance abuse among adolescents.
  • Empower adolescents and provide them with skills on how to take care of themselves and build a healthier and productive life.

Data from countries which have already adopted the curriculum shows a decrease in stigma about mental health and that people who actually needed to avail of mental health services were able to seek help. There was also earlier identification and treatment of mental health disorders in adolescents with better outcomes both for teachers and students.