We recommend that you read the Resource Booklet for Health Professionals as part of your introduction to the VIP Programme implementation. You will find useful tips and advice, as well as many exercises and lesson planning suggestions. We have also put together a booklet for students called “That’s Life” (2017) which is used by both the teachers and those who take part in class visits.

It is important that before doing a class visit, you make time to prepare for it along with other health professionals. We also recommend that you arrange a conversation, perhaps by email, with a contact teacher ahead of the class visit. During this conversation you should focus on how they have worked with the VIP Programme so far.

During the class visit, we recommend taking a 10–15-minute break in the middle of the visit where you can be available for the students in the class. It is also useful for you and the teachers to make time for reflecting on the class visit together as soon as it is completed. Make sure to bring your lunch box to join the teachers at lunch, as this can make it easier for the teachers to come up with important questions or voice their concerns about the mental health of students. Evaluation is often carried out in connection with the class visit. Check with the VIP coordinator if you are responsible for the evaluation.

These pages will give you more information on what is expected from you as a health professional in the context of VIP Programme implementation. Remember that the VIP team is here for you in case you have any questions.

Anchoring

Health professionals who have taken part in the VIP Programme implementation stress the importance of meeting young people at the classroom level and getting to know the teachers and the school culture in general. All of this makes it easier for health professionals to understand the context in which 15–19-year-olds live. At the same time, cooperation between the school and health care providers, based on the concrete steps of the VIP Programme, creates a valuable network around the students. We notice that the barrier for communication between schools and health care providers is getting lower as they become better acquainted through the VIP cooperation.

Health care providers in some districts have taken on responsibility for coordinating the VIP Programme implementation every year. This is true for the municipalities of Molde, Asker and Bærum. In Molde, the municipal mental health service acts as a coordinator. In Bærum, BUP (The Child and Adolescent Outpatient Psychiatric Clinic) cooperate with the municipal mental health service, while in Asker the municipal Children and Family Unit is responsible for coordinating the VIP Programme in upper secondary schools. The VIP Programme in Oslo receives support from Team Lavterskel (Low Barrier), which is a cooperative project between BUP and school health services, as well as from BUP Vest and the extended time they devote to schools in the Frogner and Ullern city districts.

National Guidelines also have a critical role to play in this type of school work because they can have an impact on whether your manager will prioritize contributing to the programme by arranging a class visit as part of your ordinary work.

Facilitating the students’ development of effective coping strategies is a suicide-prevention measure. Health workers who take part in the VIP Programme can help students increase their resilience in crisis situations.

Read more on the topic in The Action Plan for the Prevention of Suicide and Self-Harm by the Norwegian Directorate of Health – Note that the Action Plan is in norwegian

Your Role during a Class Visit

By visiting students and teachers, you bring your professional knowledge and experience into the classroom. During the class visit, you can touch upon the topics which the students have been exploring as part of their VIP lessons with the teacher, but you can also bring up new topics. It is important to give students the opportunity to ask their questions before the visit. A 2-hour school visit is a short time, so you will have to decide on the tasks you want to accomplish and the ways to do so. On the other hand, it is not your responsibility to discipline the class, be aware of school routines, or answer school-related practical questions. A teacher will be with you in the classroom, and it is their responsibility to address these things.

Teacher's Role in a Class Visit

It is possible that the teacher might suggest handing control of the class over to you during the class visit. However, we think it is important for the teacher to be present, and this is something you can emphasize. Say that you would appreciate having the teacher there and that they should not hesitate to come up with their own suggestions (if you are comfortable with that).

As you go along, try involving the teacher in the process where it seems relevant to do so. What is the teacher's role in relation to mental health and positive learning environment? What about the teacher's mentor role when a student is experiencing problems? Clarify with the teacher whether it is okay for you to ask students such questions in advance.  Agree with the teacher that he/she will ask you questions with the focus on helping students understand difficult words or concepts.

Methods

A common challenge during a class visit can be encouraging a good dialogue in the classroom. All classes are different and classroom environment can be experienced in various ways. The students can be reluctant to speak freely on a topic that is not on the regular school schedule. You can help the students by letting them discuss a particular topic in pairs or small groups. Be brief and precise when you suggest a question for discussion. Check if the students have understood the task correctly by walking around the class and monitoring the groups. Students are used to working in groups and do not need much time for discussion. When you sum up the ideas with the students, it is a good idea to write the key words on the board. This will be helpful both for you, as a class visitor, and for the students.

Another useful tool is short films. You will find some examples of short films that can be linked from the Internet under the section Suggestions for Class Visits below. You do not need to bring your own computer, but let the teacher know in advance that you will need a computer with an Internet connection and sound. 

How to Answer Students’ Questions

This section contains some examples of the questions students might ask as well as some thoughts on how you can answer them from a health worker's perspective.

The competence that a mental health worker brings to the classroom regarding various diagnoses, early signs of mental problems, and effective treatment, contributes to making the topic of mental health more understandable for the students.

In our experience, this is what creates the atmosphere of trust in the classroom. School health service, which includes the school nurse, is based on the idea of health promotion and aims to ensure that students will be able to improve and safeguard their own mental health and promote quality of life, abundance, and well-being in their own lives. Take advantage of these two perspectives when you are meeting with the class.

How to Protect Students When Answering Questions

It is important that the teacher, or the person who collects the questions in advance, clarifies the way the questions will be answered. Are they going to be read out in front of the class, or will they be integrated into the topics so as not to be recognized?

If you do not know what the students have been told before, it is safest to integrate the questions into your material. This will prevent the students from feeling like their question can be traced back to them. Very specific questions or questions that differ from the others are likely to distress the student when they are read out loud.

How to Collect Questions

There are many ways to collect the questions from the students. They can write their questions in groups and hand them in to the teacher, or they can write anonymous questions that are collected ahead of the class visit. Sometimes you will get questions by email several days in advance. If the class did not come up with any questions, you can use questions and topics from other classes as a starting point for a dialogue. Please see the examples of the questions below.

If the teacher has not collected questions in advance, you can hand out slips of paper to everyone before the break and ask the students to write down their questions. Those who do not have anything to ask are encouraged to write down a topic they want to know more about or just write something nice. You and your colleagues should then collect all the slips of paper and organize them during the break. However, this requires that you are able to answer some questions on the spur of the moment and get through all the questions.

How to Use Questions

As a health professional, you can link your answers to something that has already been said earlier in the meeting. For example, “Can you recover from a mental illness?”. Some of the questions may be about common attitudes toward mental health or may show a desire to demystify the topic of mental health. In that case, it could be useful to have the students discuss these questions in groups. An example of such question might be, “How can I be a good friend to someone who is struggling?”

Good discussions can have a lasting effect on students’ attitudes and give them greater resilience in life. When students get the opportunity to reflect on their own role together with others, they are better able to define their own problems and find ways to reach solutions.

As you answer questions, stick to the topic and try to be concise. All questions are relevant, but if you think that a particular one is only of interest to one or a few students, you can limit your answer. Organize your answers so that serious topics are brought up first and more positive topics such as “What can I do myself?” come towards the end of the class visit.

Examples of Questions

• “My mum has depression. Can this be inherited?”
• “What do you do if you know that your friend has an eating disorder?
• Who can you talk to, and where can they get help?”
• “If someone has nightmares every night, is this a sign of poor mental health?”
• “Can you ever completely recover after having had a mental illness?”
• “What can you do to help yourself recover?”
• “What is incest?”
• “Talk about BUP, please. ”
• “Why is smoking cannabis dangerous for the psyche?”
• “How do you know if you're transgender?”

Suggestions for Class Visits

Health professionals who are going to conduct a class visit should agree on how they will share responsibilities during the visit. The focus should be placed on teaching through dialogue so that the students have the opportunity to get answers to their questions about mental health.

Our new Resource Booklet for Health Professionals contains some suggestions on how to conduct a class visit, in addition to several exercises. The booklet replaces the old “Class Visit Guidelines”.

Below are several suggestions on how to conduct a class visit which are based on the goals of the VIP School Programme:

   
Main goal:

The VIP Programme aims to better equip students to take care of their mental health by educating the school staff and students about the topic, as well as by providing information on the kinds of help that are available.

Interim Goals:

• The students will learn more about mental health in general and gain awareness of their own feelings. They will also increase their understanding of the basics of mental health issues and disorders, as well as learn to recognise the signs of mental health issues in themselves and others.

• The students will get information on where they can apply for help, both locally and nationally, if they have a mental illness or disorder.

• The VIP Programme should act as a meeting point for the school and local mental health care providers to ensure effective cooperation. School staff will enhance their competence in the field of mental health. Teachers, counsellors, and health professionals will also receive guidance on how to implement the VIP Programme.

How to Work with the VIP Goals in the Classroom

The information here is divided according to different VIP goals. The exercises that we have posted are also available to the teachers, so it is important to discuss them in advance.

Demystification and Generalisation

Tell the students about an appointment with a young person from your clinical experience. Describe various types of treatment and how therapy works.

Mental Health in General and Normal Mood Swings

Young people will have many experiences to deal with, both positive and negative. Ask the student to give you examples of some common challenges and emphasize which signals are important to pay attention to in a life crisis. To make it more vivid, you can use examples from the media, newspaper articles, reader posts by young people, or read an excerpt from a book.

The relation between thoughts and emotions is an exciting topic for discussion. Give the students some specific tools by, among other things, showing them a short film about “Psychological First Aid”. In other words, the exercise below can just as easily be about emotional awareness.

Here you can see the exercise for the film Psychological First Aid. – Please note that the exercise is in norwegian

Emotional Awareness

It is healthy for us, as humans, to be aware of our own emotions. Explain to the students what function emotions have. Give examples of how emotions can find a physical expression. Here is an example of a group exercise that allows the students to explore, share experiences, and articulate various emotions.

Evaluation

Many schools conduct a student evaluation of the VIP Programme, and this is often done at the end of a class visit. Feel free to contact the VIP coordinator to find out if you should hand out evaluation forms after your visit. We would also be grateful if the programme participants could take part in our online evaluation. You can get a link to our online evaluation from us or from a VIP coordinator.

You will find more information, as well as evaluation forms for the students, on our page for VIP Coordinators

Class Visit Example

We have asked a health worker who has carried out several class visits for the VIP Programme to describe what a typical class visit looks like. The following is his description.

Class Visit — a Surprisingly Rewarding Experience

The first time I walked into the classroom of an upper secondary school as a VIP Programme psychologist, I had mixed expectations. Do I have anything to contribute? Is this type of teaching effective? Will the students have their attention focused on me, or will they be more concerned about each other and their iPhones?

When I left the classroom after my first class visit, I was relieved. It turned out that I had a lot to contribute. The students gave positive feedback, saying that they had “to a (very) large extent” gained more knowledge about mental health and become more comfortable speaking about their feelings. And, last but not least, they had all their attention directed at me during the entire visit and contributed actively with their questions, comments, and discussions along the way.

A Handshake for Everyone

I would like to emphasize the impact that our own expectations and prejudices can have on the outcome of a class visit. I have visited several so-called “problematic classes,” but not once have I felt that any of these warnings corresponded to my experience of the class visit.

A practical tip that I would like to share with other class visitors is to go around the classroom and shake hands with all the students in the class. This initial contact establishment will have a relationship forming and binding effect on both you and the students.

Music and Pictures

I have prepared a PowerPoint presentation that I use as a basis for my class visits. In this presentation, I have included facts and myths about mental health, information about school health services and where and how students can seek help when needed, normalization of mental distress, the difference between mental distress and mental disorders, confidentiality, human rights, loneliness, and suicidal thoughts. Additionally, I have included two films — “Styggen på ryggen” by OnklP & De fjerne slektningene and “The Black Dog”. You can find both films on YouTube. When working with “Styggen på ryggen,” I have also handed out the lyrics to all students.

I have also put together a series of inspirational images for the students to use to come up with their own associations. I have shown them images that can symbolise, among other things, friendship, heartbreak, homosexuality, family, depression, music, self-harm, loneliness, physical exercise, eating disorders, bullying, sex, and family conflicts. For every image and every association, I have asked a question related to the mental health of young people. The students have actively participated and reflected on this activity.

Be Open to Questions

No class visit is the same, and if you choose to make a presentation, I recommend that you be flexible with it. Be ready to discard the entire presentation if you are visiting an actively participating class that poses many questions. My goal with the class visits has been to make it safer for the students to talk about mental health and gain access to professionals who work in this field, as well as to lower inhibitions toward being open about mental ups and downs and to contacting health services if needed.

Being able to be part of the great achievement made by an entire class with relatively modest use of resources (one psychologist and one school nurse during 90 minutes) is almost too good to be true. VIP class visits are a great example of effective preventive measures which take advantage of the lowered barrier between mental health professionals and school staff.

I look forward to many more class visit and wish you the best of luck with yours!

Best regards from Per Martin Løken

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