Social networks to support mental health
Moving to Malta
Our childhood years are meant to help us develop our sense of identity, belonging, culture, and home. But what happens to those for whom childhood is dominated by moving to a new country with a new language, culture, and social norms? Prof. Carmel Cefai speaks to Becky Catrin Jones.
It’s a small world these days. Developments in technology and transport mean it’s much easier to pack your bags and head off for a fresh start in a foreign land. For many, the destination is Malta. As a beautiful island in the Mediterranean Sea with a booming economy, it is no surprise that it’s drawing the attention of bright sparks and aspiring families from Europe and beyond. In fact, Malta currently boasts the fastest growing EU population.
Of course, it’s not always through choice that you might find yourself leaving your homeland behind. Humanitarian crises and ongoing wars in North and sub-Saharan Africa and the Middle East have seen thousands set sail under the most treacherous conditions in search of safety. For this population, Malta is often the first port of call between the dangers of home and the promise of hope in Europe.
It seems strange to group these populations together, given the stark differences in the journeys that bring them to Malta and the life they seek here. But together, this influx of people has contributed to a sudden rise in interculturalism, where people from different backgrounds interact and influence one another. This is a reality all parties are having to adapt to.
Even in a fairytale scenario, childhood is challenging. Growing up when you’re far from home, look different to everyone around you, and don’t speak their language, makes the challenge reach a whole other level. Children’s wellbeing is an increasingly important and emotive topic to study in Malta, which is a signatory to the United Nations Convention on the Rights of the Child. A team of researchers from the Centre for Resilience and Socio-Emotional Health (University of Malta), set out to explore the situation. They questioned: How do you settle into a new home and identity when you are still trying to figure out who you are and where you are from?
Finding the voices
Children are often a silent group. When analysing the wellbeing or effect of migration on a population, they are usually spoken for by adults. For this study, however, Prof. Carmel Cefai and his team wanted the child’s voice as well. The scope of the study was ambitious; every single contactable, non-Maltese child living in Malta was invited to take part and share their experiences. But this was a challenge.
‘Identifying and obtaining access to foreign children from age zero to 18 was not easy… Some schools suffered from research fatigue and did not wish to participate; whilst translation of instruments and data and use of interpreters drained the limited budget we had for this project.’ Maltese children were contacted and invited to participate too. After all, they are as affected as anyone else when around one in ten of their schoolmates are not Maltese.
The study focused on four main areas; social interaction and inclusion, education, subjective wellbeing and resilience, and physical health and access to services. They covered the experiences of children up to 18 years of age, from various schools, who were either settled into their own family houses or still in open shetlers following a difficult journey to Malta. They also aimed for a balance in migrants’ nationalities; European, North American, African, Middle Eastern, or East Asian; as the experiences of each population are understandably different. Cefai and his team found that the experiences of migrant children in their everyday life are quite positive. In some areas, even more positive than those of Maltese children, with only 8% reporting difficulties in their psychological wellbeing compared to 10% in the native population. Overall, they found that migrant children feel safe, listened to, and cared for by the adults in their communities. Despite the language barriers, most feel like they have a support network, and enough friends though more often than not those friends are other foreign children, not Maltese.They are able to keep up at school, and generally do as well as their Maltese peers, with teachers reporting high levels of engagement.
Adapting to a new world
All is not rosy. Bullying in schools is quite common, though less frequent than that reported by native Maltese children. One in five migrant children also do not feel they have enough friends.
Younger children seem to be more included and engaged than secondary school ones, and in general females fared better in the study than male classmates. That said, age and gender weren’t the main influencers when it came to predicting how well the children engaged at school and in their communities. ‘The study suggests that there are different layers of reality, with the big picture hiding the socio-economic, psychological, and social difficulties encountered by a substantial minority,’ remarks Cefai.
Unsurprisingly, those who speak Maltese feel more engaged than those who don’t, and those who aren’t confident in English are in an even worse position. However, the factor producing the biggest differences between the overall wellbeing, health, and education of the children is their country of origin. ‘The health, wellbeing, and relative comfort enjoyed by many children of European economic migrants contrast sharply with the poverty, poor accommodation, psychological difficulties, learning difficulties, and experiences of discrimination of many children from Africa and the Middle East’, says Cefai. Western Europeans and American children scored highly over all criteria, whereas African and Middle Eastern children are far more likely to be lonely or suffering from social or economic difficulties.
They are more likely to be less proficient in English, which leads to difficulties in making friends with children from other cultures and which also contributes to problems in their education. Although they are generally nourished by their spiritual and religious communities, in all other areas these children report social and emotional difficulties and are also more likely to report facing prejudice and discrimination. Healthcare proved problematic; many parents and children worry that they are subjected to discrimination whilst using services, or do not have enough information to use them in the first place.
A land of opportunity
Despite the additional challenges that these particular migrant children face, the overriding feeling is one of acceptance and hope. Even children in open centres view Malta as a land of opportunity, even when some are in suboptimal housing and lack basic necessities. What children in open centres do not perceive is Malta as their home. Better living conditions in the community, more cultural sensitivity, and openness to interculturalism may help to reduce the feeling of ‘us’ and ‘them’.
So what do Maltese children think? Again, the overall conclusions show that children are open, tolerant, and welcoming of this dramatic and quick rise in multiculturalism that has happened. However, on closer inspection, it seems that there is still a way to go before we can truly call ourselves an open and accepting society.
Relatively few Maltese children have many foreign friends, preferring to spend time with native peers. This hesitation is stronger in children who aren’t from a mixed community, whereas children in independent schools and more exposed to foreign children seem more at ease with the idea that the future might be even more multinational and intercultural. As many as one in three Maltese children also report feeling unsafe in culturally diverse communities, and worry about potential negative consequences of these changes in the future. There also appears to be particular prejudice against children from Africa and the Middle East in contrast to children from Europe, the US, Canada, and Australia.
What has become clear is that both foreign and native children could do with some reassurance. So what do Cefai and his team suggest we can work on to help everyone embrace this new culturally diverse reality?
A united future
‘[We need] to address the needs of marginalised and vulnerable children, particularly those coming from Africa and the Middle East’, says Cefai. There’s also a lot both populations could learn from each other; caring for their environment, sharing cultures, or even adopting healthier lifestyles. By encouraging more open and judgement-free spaces to play, learn, and share, we’ll take away the ‘us’ and ‘them’ ideology from a young age and replace it with one of acceptance, curiosity, and openness to new ideas. This will help prevent the dangerous spiral of segregation and ghettoisation, seen all over Europe.
Cefai suggests a space for more positive role models for those migrant children thrown into a foreign culture that doesn’t seem to have space for them. Having teachers, healthcare workers, or even political representatives who have similar backgrounds will foster this inclusive nature, showing that everyone has a voice when it comes to working together to make this country a home for all.
There’s work to be done with Maltese children. ‘Whilst it is encouraging that the majority hold positive attitudes towards interculturalism, it is worrying that as they grow older children’s attitudes tend to become less positive,’ says Cefai. ‘It’s our responsibility to ensure that educators, community leaders, and parents of Maltese children are part of a national initiative to embrace interculturalism.’
Although overall a positive study, Cefai and team have shown we still have a way to go until every child in Malta feels safe, happy, and at home. And in this ever-changing and diverse environment, Malta has real potential to be an example to its neighbours on how a successful multicultural society can work on every level. These children are our future.
On mindfulness
In this overwhelming world of apps, chats, commercials, and instant everything, we’re fighting for our attention at every turn. We sometimes barely have time to think about our decisions, often regretting what we did or what we bought a short while later.Resurrected from old Buddhist teachings, mindfulness is being touted as the answer to the varying needs and demands of modern society. New-age ‘gurus’ offer courses that claim to change our life in seconds. To me, this has always sounded like a mission impossible.
Daydreaming poses a challenge for me. Ideally, it should give us the space to absorb new information and figure out potential options for future decisions and behaviour. But most of the time, programming takes over. We mentally analyse events and their effects—we worry—failing to be present.
The ability to create a mindful space in our thoughts can be developed through regular mindfulness meditation. The practice involves a lot of deep breathing, slowing down, observing our passing thoughts, and absorbing our surroundings. There are even apps to help boost our levels of mindfulness.
While this might seem like fluff to some, studies have found clear evidence for the positive effects of such practice. Meditation has been shown to have a positive effect on well-being and emotional regulation. Some research also shines light on its therapeutic benefits for anxiety and depression. Research shows that mindfulness gives us extraordinary insights. Those who practice regularly say that they experience the present reality to a sharper degree, absorbing small details that usually get lost. Imagine, instead of automatically reacting to your surroundings, being able to focus in the moment so that you can actually choose your next step with intention. That is power!
Personally, I found that a month of dedicated practice sharpened my attention. I started noticing small things and gestures that, before, would just pass me by. It drove the amount
of wasted time down significantly. I made better decisions. It wasn’t easy to sit there with all my thoughts, but it definitely trained my mind to overcome challenging tasks.
We can all benefit from regular mindfulness practice. Go on and try it for yourself. Take a deep breath, slow down, and pause. Seize the moment. Be.
Further reading:
Cocoran, K. M., Farb, N., Anderson, A. & Segal, Z. V. (2010). Mindfulness and emotion regulation: Outcomes and possible mediating mechnanisms. In A. M. Keing & D. M. Sloan (Eds.), Emotion regulation and psychophatology: A transdiagnostic approach to etiology and treatment (pp. 339 – 355) New York: Guillford Press.
Hoffman, S. G., Sawyer, A. T., Witt, A. A., & Oh, D. (2010). The effect of mindfulness-based therapy on anxiety and depression: A metaanalytic review. Journal of Consulting and Clinical Psychology, 78, 169 – 183. doi:10.1037/a0018555
Author: Sofija Borojevic
Training to temper: Emotional learning for young people
Over the last decade, workaholics have been glorified as the epitome of success. Problem behaviour is increasingly framed as ‘interesting’ and ‘quirky’ by certain media. But as mental health and well-being capture public attention, Cassi Camilleri speaks to Prof. Carmel Cefai about his efforts to promote social and emotional learning for children and young people—skills for a lifetime.
Life is life, they say. Trial and error. You live and learn.
But how many times have you been frustrated with yourself because you ‘never learn’ from your mistakes?
How many times have you found yourself in a rough spot because deadlines are a dime a dozen and your to-do list is insurmountable? Your phone is ringing off the hook. All the people you have been ignoring are sending angry emails. You have not slept properly in days. All the while, you continue to dig your heels in, creating more issues with the people around you because you are so overwhelmed you cannot communicate like a decent human being. You are 40. Still think learning from experience is the only way you can go about this?
Human beings love patterns, routines. We love repeating what works. We also tend to repeat what doesn’t though, because change is hard. But solutions exist. At the University of Malta (UM), Prof. Carmel Cefai (Faculty for Social Wellbeing), is hard at work pushing for social and emotional education (SEE) to be promoted and strengthened at all levels in Malta and Gozo.
His appreciation for the importance of relationships and addressing students’ emotional needs in learning started over 40 years ago when Cefai was working as a primary school teacher. ‘Getting to know the students individually, what they like, what makes them tick, providing individual attention according to their needs, was an important part of the teaching process. When I was teaching at Qormi, on Monday mornings my students and I would talk about horse racing—which horse won which race that weekend? I learnt many of the horses’ names even if I wasn’t that interested in horse racing. But then during the week we ended up using horses as examples during class. It was a good and easy way to engage students.’
Cefai agrees that while overprotecting young people is counterproductive, students should have the skills to make informed choices, avoid taking too many unsubstantiated risks, and make some but not too many mistakes. ‘We do not need to experience highly stressful, painful, or traumatic experiences to learn or grow. The process of growth does not require that we become dependent on alcohol or drugs, engage in criminal behaviour, contemplate suicide or struggle with depression.’ Playing devil’s advocate, I say that such experiences provide their own brand of wisdom, but Cefai quickly retorts that whatever the takeaway may be, even if it is a positive: ‘the price paid is much too high.’
Where do we begin?
The majority of western culture, including Maltese, has a very particular problem when it comes to education—the whole process is vehemently geared towards academic achievement. There is a pervasive obsession with tests and grades. So the first thing we need to do, states Cefai, is move away from that. ‘Education is not just preparation for work. It’s also about the integration of cognitive, social, and emotional processes that make us human. If we provide an education based only on academic achievement, we will be shortchanging our children and depriving them from a good, quality preparation for adulthood,’ he says—the whole aim of education.
Rather than what kind of jobs people do, or what successful businesses need, as educators we need to ask: what kind of life would this child or young person be happy living?
SEE is the process by which an individual develops social and emotional competence through curricular, relational, and contextual approaches, skills that can be used for personal, social, and academic development. The concept already has a proven track record, Cefai notes. Where successfully implemented, SEE ‘has already brought about a paradigm shift in education, […] transforming it into a more meaningful, relevant, and humane process.’
Malta has come a long way already over the last few decades. Cefai remembers when, as a primary school teacher, he had tried to support a young school child with mental health difficulties who was not only ridiculed and bullied by the other children, but also shunned by adults because of his ‘odd’ behaviour. ‘The boy clearly needed help from specialised professionals,’ notes Cefai. ‘But he also needed to attend school and learn with people his age. The alternative was to stay at home, which he inevitably did because he was often absent.’ Thankfully, things worked out in the end. ‘With the help of the head of school and some professionals, we managed to make some inroads and his behaviour started to improve. But I remember back then struggling with lack of professionals, fragmented services, and rampant stigmatisation.’
The situation has continued to improve since then. Cefai promptly lists the good practices which are already in place. ‘We have Personal, Social, and Careers Education which has been in schools for years now. There have been various national initiatives promoting students’ well-being, all working to prevent school bullying and violence, early school leaving and absenteeism, as well as to promote inclusion in all shapes and forms. Many colleges and schools have also been engaged in various initiatives to promote social and emotional learning, such as Circle Time, Restorative Justice and Resilience building.’
Not only that, but Cefai himself has worked with colleagues at the UM to found the Centre for Resilience and Socio-Emotional Health at the University, as well as with European counterparts to set up the European Network for Social and Emotional Competence. ‘Our centre has been quite active over the years in providing training for school teachers in these areas, particularly in resilience development. We are also presently working with the Ministry on SEE training of practising staff in the early years,’ he adds. But there is still much more to be done…
Priorities
Children’s development can be badly affected if their social and emotional well-being is not adequately addressed, says Cefai. This gap in emotional learning allows for educational systems to be driven primarily by market economy needs. Rather than what kind of jobs people do, or what successful businesses need, as educators we need to ask: what kind of life would this child or young person be happy living? The market-driven approach is focused on performance, individualism and competition, with little time and space for collaboration, sharing, compassion, and solidarity. Sadly, this situation is seen all too often.
So, how do we fix this? How do we make SEE a priority? Cefai immediately runs off a list of to-do’s. ‘We need to give social and emotional education more space and time in our schools. We need to invest more in teachers, giving them better training, and supporting them in taking care of their own health and well-being,’ Cefai emphasises. ‘Only when teachers take care of themselves and their well-being can they really create healthy, caring classroom environments where people build healthy relationships. It’s only then that they can respond effectively to students’ needs and become good role models.’ We also need to put more effort into the early years, when the building blocks of mental health and well-being are laid. We need to encourage schools to take a more holistic approach, to give students a stronger voice, to encourage parents to take a more active, participative role in their children’s education.
Of course this is not all achieved at the snap of our fingers. Resistance is to be expected, nods Cefai. ‘In order for SEE to work, there needs to be good quality planning, implementation, monitoring, and evaluation. We know of state-of-the-art programmes which failed to make an impact as they were not implemented well, such as the Social and Emotional Aspects of Learning (SEAL) in the UK which was eventually withdrawn because of lack of effect.’ Looking into reports about SEAL, ‘a superficial approach to implementation (‘box ticking’)’ was one of the main reasons the program failed.
Cefai also says that we need to be careful at all stages to avoid hijacking agendas. ‘Social and emotional learning should always be centred on children and young people’s needs. Their own and others’ well-being. We need to ensure that SEE retains focus on the people it is meant to help, recognising individual differences, while avoiding labelling and pathologising children and young people. SEE is about mental health promotion and well-being and prevention, rather than on deficiencies, deficits, and illness. Another issue is not to let SEE be taken over by the neo-liberal ’business model’ to fuel the market and global economy, where social and emotional skills are simply used to leverage productivity.’ Despite all this, the case for SEE remains tremendously strong.
There are no losers here
A success story in SEE implementation is a success story for everyone. Reams of evidence through studies can be found touting SEE’s praises. The approach enhances prosocial behaviour and mental health and well-being. It enhances academic achievement and prevents problem behaviours such as delinquency, anxiety, and depression. Such social issues cost taxpayers money to handle, mitigate, and fix. So much so, that the costs involved in setting up SEE are guaranteed to be not only returned, but exceeded. Some studies report that for every €1 invested, €11 will be returned to the economy in various shapes and forms.
‘I have been involved in various SEE and resilience projects in schools both in Malta and abroad,’ says Cefai. ‘I have always been very encouraged by the interest, enthusiasm, and collaboration of students, school staff, and parents. Staff and parents have been resistant at times, thinking it will take precious time from academic learning, until they realise that our approach actually enhances it. They may think that SEE is about mental illness, until they they realise that is about health and well-being and learning all rolled into one. Children really like to learn in this way, finding it enjoyable, meaningful, and useful, while teachers reap the satisfaction of seeing their students excel, improving their own lives through their contribution.’
So much of our lives are determined by our beliefs and perceptions. Learning how to process events and information in an effective way can make all the difference in how sequences of events unravel. That violent knee-jerk reaction, that long-standing bitter belief about ‘how the world works’; in difficult times, these thoughts can lead anyone down a long, dark path that’s very difficult to come back from. Social and emotional education that teaches young ones to listen to themselves and respect their feelings, as well as those of others, could begin to change that.
In a world where we are bombarded by stimuli every waking moment, it is not hard to imagine that we need to take the time to look inward and listen—our children depend on it.
Prof. Cefai has recently published three major publications in this area: An EU commissioned report on the integration of social and emotional education in the curriculum, an edited book on the promotion of mental health in schools and another edited book on the child and adolescent well-being and prevention of school violence.
Read more:
Cefai, Carmel, and Paul Cooper. Mental Health Promotion in Schools: Cross-Cultural Narratives and Perspectives. Sense Publishers, 2017.
Cefai, C. et al (2018) Strengthening Social and Emotional Education across the Curriculum in the EU.Review of the international evidence. Luxembourg: Office of the European Commission.
Author: Cassi Camilleri
Social Wellbeing Policy at University?
University can be incredibly stressful. Staff perform high level work with plenty of academic responsibilities, while balancing a private life and leisure time. The number of students at University is rising every year. For academic and support staff this means a more intensive workload, pressure, and stress. For students it is the pressure of attaining good results, maintaining relationships, and other social and emotional wellbeing issues, such as coping with peer pressure, struggling with deadlines, and worries about the future. Numerous studies suggest that examinations negatively impact on student health and wellbeing. Some coping strategies and time management programmes have evolved at the University of Malta, for example by the University Chaplaincy. Such well-meaning initiatives are good and do good, but tend to happen sporadically and around examination time.
Many University of Malta students balance multiple identities. They often fall outside the typical demographic of an 18-year-old sixth form school leaver. Our students come from diverse socio-economic backgrounds, and may be studying full-time or part-time, with a variety of life roles: mature students, women with care responsibilities, persons challenged by disability or facing problems due to sexual orientation. Whatever the situation in life, each diverse identity places increased demands upon the students’ time and private life. These demands influence their University experiences, study perceptions, and learning style. Their peers might treat them differently due to their background.
“A social wellbeing policy will help foster confidence in its approach to academic learning, and to eliminate discrimination in favour of a more inclusive learning environment”
Besides worries about assignment deadlines and writing exams, many students are also in employment. I am not sure this trend is in line with University of Malta regulations, nevertheless, that is the situation. Students also worry about future prospects with no guarantee of secure employment after finishing their studies. So it is not only academic concerns that come in the way of student social wellbeing, and these may lead to high levels of stress, anxiety or frustration, depressed mood, difficulties with time management, procrastination, poor concentration, withdrawal from friends or family, or physical symptoms such as headaches, sleep problems, and exhaustion. University life presents numerous stress factors that may trigger off mental health difficulties.
Students experiencing stress are normally recommended psychological intervention and counselling, which may be beneficial for extremely stressed students. However, research suggests that physical activity helps improve mental health and wellbeing. The University of Malta, through its Work Resources Fund, promotes cycling through the Green Travel Plan. The initiative is more about sustainability and the environment, apart from a solution to the parking problem. However, cycling does improve our mental health and wellbeing, and is a free personal de-stressor by taking our mind off work or study, and leads to healthier lifestyle choices. 
A social wellbeing policy for University will help foster confidence in its approach to academic learning, and to eliminate discrimination in favour of a more inclusive learning environment. Indeed, the principles of equality and diversity such as gender or disability are essential for a true understanding of social wellbeing, and these same principles need to be included in our University’s policy document and implemented in practice. Diversity in a dynamic, intellectual environment enriches professional and educational experiences for both staff and students.
Diversity on campus is needed and important for a healthy University. Internationally, social wellbeing on campus is being promoted through an organisational structure embedded into the ethos, culture, policies, and daily practices of a university. A social wellbeing policy includes an improved occupational health and safety system, and a commitment to address mental wellbeing, physical inactivity, unhealthy eating and substance misuse. The University needs constant commitment to positively influence the life and work of all staff and students.
The University is encouraged to guard the integrity of its communication system. Collaboration and open communication fosters conversations and relationships necessary to bring about social wellbeing. The communication process needs to be trusted and confidential for team spirit and social wellbeing. For instance, I would strongly argue for an email policy that discourages unnecessary use of bcc in emails, as the practice of not telling the original addressee is unethical and downright deceitful.
The University of Malta could establish itself as a national contact point on the European Network for Health Promoting Universities (see www.eurohpu.aau.dk). It would commit the University to place social wellbeing high on its policy agenda. A working document published by the World Health Organisation Regional Office for Europe provides guidance on how to set up and develop a health-promoting university project, which would enhance and protect the social wellbeing of all staff and students.
Finally, I would also suggest an exploratory research study about aspects of university life, stress factors in teaching and learning activities, and how these impact on individual experiences. The aim is to understand the general quality of life, and how this can be improved for an informed social wellbeing policy document at the University of Malta.
This article is based on a paper Camilleri-Cassar presented at a seminar organised by the Faculty for Social Wellbeing in October 2013.
Read more here:
– Carroll, A. (2011) ‘Exploring the link between equality, diversity and wellbeing.’ In Marshall, L. and Morris, C. (eds) Taking Wellbeing Forward in higher education: reflections on theory and practice, University of Brighton Press.
– Hagarthy, D. and Currie, J. (2012) ‘The Exercise Class Experience: an opportunity to promote student wellbeing during the HSC’, Journal of Student Wellbeing, vol. 5(2):1-17.
– Hall, C., Ramm, J. and Jeffery, A. (2011) ‘Developing the University of Brighton as a Health Promoting University: the story so far.’ In Marshall, L. and Morris, C. (eds) Taking Wellbeing Forward in higher education: reflections on theory and practice, University of Brighton Press.
– UniHealth 2020: Mission Statement, www.eurohpu.aau.dk