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Thank You NHS in graffiti

How to Be Health Literate

Nicola Biggerstaff

With all the emphasis being placed on wellbeing in education, why is the collective wellbeing at rock bottom? What is going wrong in a society that emphasises awareness and taking charge of our own health, especially in schools following Covid, yet we’re witnessing continued pressure on ambulance and A&E waiting times, hospital and general practice capacities. Is this a sign of a completely broken healthcare system? Undoubtedly. But there must be something we can do to help?

As a key pillar of the Curriculum for Excellence in Scotland, presenting Health and Wellbeing outcomes as a lengthy booklet of tables and bullet point key targets is not the way to approach this. Teachers are being told that CfE has removed the need for ‘ticky box exercises’, only for key stage targets to be replaced by… ticky box exercises.

On one end of the spectrum, we have pupils in our education system becoming increasingly aware of mental ill health, and taught how to spot the signs and symptoms as part of the Health and Wellbeing outcomes, but are not taught what to do about it. It should be, it’s on the list.

Meanwhile on the other side, we have people who, through the brutal cuts to our health services in the last 20 to 30 years, have become completely health illiterate, with no idea who to turn to when they have a problem. People who will turn up to their local GP practice as a first port of call into the health service, having been turned into a glorified triage for referrals to specialised services, or turning up in A&E for issues which are not life threatening. Both branches are now under an immense pressure, creating bottlenecks which prevent more urgent cases being seen on time, creating even more issues as a patient’s condition deteriorates further without timely treatment.

How do we show people how to navigate the system effectively? Shouldn’t this be taught in school through their personal and social education (PSE) classes? Well, not in my experience. Aside from the pre-CfE equivalent of mental wellbeing, and ‘the talk’, my knowledge of accessing healthcare came from the home. How did I know you needed to know your address and postcode by heart to collect a prescription from the pharmacy? My dad told me, when he asked me to collect his for him when he was too busy. How did I know I could only book a GP appointment on certain days  after the latest round of cuts to rural services? My parents told me. How did I learn that Out of Hours services even existed? When we had to use them for the first time.

This doesn’t mean we don’t learn important health topics in school at all – one of my earliest memories of health education was roleplaying to learn when and how to call 999. Moving into senior phases, the importance of learning the signs and symptoms of overdose on various drugs and knife crime dominated. Good to know, of course, but not what I needed.

This also does not mean that schools haven’t adapted in the (slowly increasing) number of years since my school days. Most schools incorporate some level of basic mental health training for staff, some even have mental health hubs where pupils can consult with staff who have received more in-depth mental health training.

But ‘tell your teacher if you’re feeling sad’ is an unfair burden to place on an educator. It’s great that pupils nowadays feel so comfortable in their school environment, but teachers are limited in what they can do other than kick the issue up the chain.

Most NHS and private practices are running on so many varying systems, and all work so differently, there couldn’t possibly be a single model for teaching when and how to access your own healthcare as it stands today. How is a teacher from a different area going to know that some of their rurally-based pupils can only phone for an appointment on Tuesdays and Thursdays, because that’s the only days the practitioners from the next town over travel in to run the local surgery?

It’s an impossible balance to strike in the real world. This is the line on which wellbeing education and parental responsibility collide. Education should always extend beyond the classroom, but not all pupils are afforded such in their home life.

Imagine if this is something we could begin to teach: if someone is not breathing, dial 999. If someone has broken a bone, dial 111. If you need pain relief, go to a pharmacy first. Then moving to, an assignment on how your own GP surgery operates? Create a list of services available to you locally. Where is your nearest A&E? Mark it on this map.

It seems so simple, and yet so many of us have been left in the dark about what’s left of our health services that incorporating this into a wellbeing curriculum makes the most sense. Some of the pressures we’re seeing in our healthcare system could be alleviated almost instantly.

But haven’t teachers got enough to do?

Well, this doesn’t have to be provided by teachers. Healthcare professionals give talks in schools all the time, why not incorporate this into a semi-regular, classroom setting? Teachers do have enough to do already: let them teach, let the local authority invest in expanding pastoral support. This is the Common Weal message.

This is before we even begin to consider the benefits, as we present in Sorted, of a widened and adequately funded care service, working in tandem with an adequately resourced health service, to prevent many of the issues we see today from arising in the first place. In an ideal, Common-Weal-tinted-glasses world, we would have someone who is experiencing mental distress, for example, being brought to the attention of their local care team, who would ensure an adequate package is put in place to support them in their recovery. This person would hopefully never even have to enter the health system at all, provided this was sufficient, and would only require medical intervention if their condition deteriorated outwith the capacity of care (i.e. if their initial distress was caused by a serious, undiagnosed condition, as opposed to anxiety or depression caused by outside factors).

In an education setting, a pupil experiencing a mental or physical health problem would have a number of options to enter the NHS or NCS for treatment. Having been taught in their wellbeing classes which issues required which services, they could self-refer with parental supervision, or contact their community health professional. If they were uncomfortable doing this, or were still unsure which service to contact, they could contact one of their health or care professionals within their school – having already been taught in their wellbeing class which would be more appropriate to approach based on their needs – who could direct them to the required services.

Early intervention is key for both healthcare and health education. The sooner a pupil is taught how to navigate their health and healthcare, the sooner it becomes second nature and, obviously, the faster a patient is treated, the better their recovery outcomes will be. Let’s not let ourselves get into this mess again, and let’s not make our kids suffer for it.

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