AKU-IED’s Ayesha Shahid Mehmood on Why Schools Must Move From Mental Health Awareness to Action

Pakistan’s children and adolescents are dealing with rising levels of stress, anxiety, bullying and social pressure, and schools are often where the first signs show up. A child labelled distracted or uninterested may in fact be struggling with something far deeper, yet many teachers have limited training in telling the difference.

To mark World Mental Health Day, ProPakistani spoke with Ayesha Shahid Mehmood, Assistant Manager for Inclusive and Special Needs Education (ISNE) at the Aga Khan University Institute for Educational Development (AKU-IED). Drawing on her experience in education, she explains how schools can recognise warning signs early, why teachers need training built around their actual classroom concerns, and how parents, counsellors and administrators can share responsibility for student wellbeing instead of leaving it all to one person.

She also covers what age-appropriate mental health education could look like, how an effective referral pathway should work, and three changes schools can begin making right away. Her central point is that spotting a problem early is a shared responsibility, not a job for teachers or counsellors alone, and that schools do not need to turn teachers into clinicians to get there.

1. Pakistan’s children and adolescents are facing growing concerns around stress, anxiety, bullying, social pressures and other mental-health challenges. From your experience in education, how well equipped are our schools today to recognise these concerns at an early stage?

Greater awareness has encouraged more open discussion about mental health, and schools are hiring counsellors, involving parents, and conducting bullying awareness campaigns. However, concerns are still not always recognised early.

Children may be labelled as uninterested or distracted when they may actually be dealing with other concerns. Although teachers are becoming more aware of ADHD and autism, limited training can make mental health challenges harder to recognise.

Teachers need basic knowledge to identify concerns and know when to refer children to professionals. Counsellors should communicate effectively with teachers, while the whole school team, including parents, shares responsibility for children’s mental wellbeing.

2. Schools are often the first places where changes in a child’s behaviour, learning, attendance or social interactions may become visible. What signs should teachers and school administrators be trained to recognise as possible indicators that a student may be struggling with their mental health?

Early signs can include headaches, sleepiness in class, not attending classes, appearing zoned out, declining grades, feeling scared, avoiding people, spending excessive time in the washroom, shivering, or unexplained physical marks. Other signs may include vomiting, feeling unusually hot, sweating unnecessarily, or constantly moving their legs.

We had a case where a student had marks on his hand. I recognised them, as did his school counsellor, although the child said they were caused by his cat. Teachers should pay attention to such signs.

Children may also open up to art teachers, so their essays and drawings should not be ignored. Regular check-ins with homeroom teachers are important.

3. Mental-health education is still largely absent from mainstream school curricula in Pakistan. What would age-appropriate mental-health education look like at different stages of a child’s schooling, and how could it be integrated without adding another burden to an already crowded curriculum?

Many issues are already discussed across subjects, such as pollution in Social Studies and social and global issues in Literature. Mental health can similarly be incorporated into the curriculum as an important concern.

However, highly criteria-based subjects like Arts can limit students’ opportunities for free expression and create unnecessary pressure. Since individuals think and express themselves differently, mental health topics should be introduced according to age. For younger children, circle time, awareness videos, poems, worksheets, and activities around emotions can help. Older students can engage through social stories, skits, group sessions, guest speakers, projects, and visits to mental health organisations to broaden perspectives and reduce stigma.

4. There is often a misconception that bringing mental health into the classroom means teaching children about mental illness. How can schools instead use social and emotional learning to help children develop skills such as emotional regulation, resilience, empathy, communication and healthy relationships?

Mental health is not only about discussing problems; it is also about improving wellbeing. Morning greeting time and regular conversations with students can help teachers understand what is happening in their lives beyond academics. Schools can also dedicate an extra hour each week to activities involving both teachers and students. At the same time, schools should recognise that educators come from different backgrounds and may have their own challenges. Providing counselling services for teachers is important so they can support children effectively. As it is said on planes, you should take care of your own safety first so that you can help others. The same principle applies to educators.

5. Teachers are not mental-health professionals, yet they are often adults who spend the most time with children. What kind of training and support do teachers need to identify concerns, respond appropriately and know when a child needs professional help?

Teachers are not mental health professionals, but those who create safe spaces often become the people the whole school turns to, which can become overwhelming. Schools should first conduct a needs assessment with teachers to understand the specific concerns they face. Early years teachers may deal with behavioural issues such as hitting, spitting, or inappropriate language, while older students may face bullying, harassment, low self-confidence, or social anxiety.

Training should be developed according to these needs because one training cannot address everyone’s concerns. Schools should involve relevant professionals and provide follow-up sessions, as one day may not be enough. Behaviour therapists or professionals trained in Applied Behaviour Analysis can support behaviour-related concerns, while clinical psychologists can help with anxiety-related issues.

6. What role should school leaders, counsellors and administrators play in creating a school environment where children feel safe discussing emotional or psychological difficulties? What institutional changes are needed beyond simply appointing a school counsellor?

A support system cannot work in isolation. Schools should be open to discussing concerns and provide training based on the problems teachers face and the concerns students bring to them. Students may approach administrators with different concerns and counsellors with others, so issues should be referred to the appropriate person when needed. Everyone in the school hierarchy should feel accessible to students.

While schools need rules, consequences, and firmness, they should also provide a safe environment where education, character development, and mental wellbeing can develop together. Coordination among the entire school staff is essential. Movies like Hichki and Dead Poets Society provide good examples of educators going beyond the classroom.

7. Stigma can prevent children from speaking about anxiety, depression, bullying or other difficulties and can also make parents reluctant to seek professional help. How can schools involve parents and families in building a more open and informed approach to children’s mental health?

Mental health stigma is created and reinforced within society, partly because mental health concerns are often invisible and receive less attention. An informed approach should begin with a needs assessment of the school community, considering different social backgrounds and types of stigmas. Families may respond differently to a child’s condition, including treating the child differently or facing challenges with social acceptance. Awareness should therefore be tailored to the community. Schools can involve parents through awareness and activity-based sessions, parent committees, counselling, mothers’ yoga, and connections with therapists. Positive reinforcement for participation can create a ripple effect and encourage supportive attitudes.

8. Schools should not be expected to diagnose or treat mental-health conditions. What would an effective referral pathway look like in Pakistan, from a teacher noticing a concern, to school-level support, parental involvement and, where necessary, assessment and care by a qualified mental-health professional?

The first concern should be understood by all teachers and support staff, as different people observe different aspects of the same child. For example, in Taare Zameen Par, Ishaan struggled not only with reading and writing but also with tying his tie, shoelaces, and getting to school on time, showing difficulties with executive functioning. The concern can then be discussed with the coordinator to identify appropriate accommodations and review their effectiveness. Parents should also be involved to share the child’s performance at home. If professional support is needed, appropriate assessment should be conducted, followed by an individualised plan with suitable accommodations and modifications.

9. The World Health Organization recognizes school-based social and emotional learning programs as an effective approach to promoting mental health and recommends mental-health support in non-health settings such as schools. What lessons can Pakistan draw from this approach, and what would it take to adapt it meaningfully to our own educational and cultural context?

Social learning programmes are being implemented in early years, preschool, and primary classes, but there is less focus on secondary years and children above age seven. Mental health concerns may not be very visible at ages four or five, but they often begin emerging after age seven. Therefore, the approach should extend to this age group. Schools could introduce a separate hour for mental health and wellbeing, just as they give attention to other activities during the week. Mental Health Days or Mental Health Weeks could also be introduced, with different activities conducted to engage students and promote awareness.

10. If you could identify three practical changes that Pakistani schools could begin implementing immediately to better support the mental health and wellbeing of children and adolescents, what would they be—and what should schools avoid doing despite having good intentions?

I would identify three practical changes for Pakistani schools.

First, schools should conduct needs assessments and provide relevant training. Every age group and classroom has different concerns, so training should reflect teachers’ actual needs. Teachers should recognise early signs, respond appropriately, and know when to involve a counsellor or relevant professional, without being expected to act as mental health professionals.

Second, schools should establish regular communication and check-ins. Morning greeting time, homeroom check-ins, and conversations beyond academics can help teachers understand what is happening in a child’s life. Parents should also be involved to share how the child is doing at home.

Third, schools should create regular opportunities to discuss wellbeing, particularly beyond the early years, through Mental Health Days or Weeks, activities, discussions, and creative expression.

Schools should avoid one-size-fits-all approaches and placing the entire responsibility on the counsellor. Most importantly, they should avoid labelling or blaming children and instead focus on understanding their concerns and providing appropriate support.

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