Mental Health Continuum

Understanding the difference between mental health and mental health conditions

Mental health and mental health conditions are different and exist on a continuum

At one end, Flourishing represents optimal functioning in which a child or young person feels good, functions well, relates well with others,and approaches their learning with purpose, curiosity and optimism.

Next are children and young people who are Going OK. They experience good mental health and an absence of frequent or significant feelings of distress.

In the Struggling range are children and young people who may come to the attention of educators due to more noticeable but generally time-limited periods of distress which have a mild impact on their behaviour, learning and relationships.

These experiences may either be a) an expected part of development and growing up, b) an expected emotional reaction to challenging life circumstances, or c) the early signs of an emerging mental health condition.

Finally, children and young people at the far right-hand-side of the continuum have thoughts, feelings and behaviours that are distressing and have a severe impact on everyday activities.

Children and young people shift back and forth along the continuum

Mental health changes over time in response to different stresses and experiences. There are many factors, both internal and external, that affect where someone generally sits on the continuum, and also where they sit at any given point in time.

Most children and young people sit at the positive mental health end of the continuum, most of the time

In your everyday role as an educator, you help nudge them towards Flourishing and reaching their full potential in the way you promote their social, emotional and academic development.

However, many children and young people will demonstrate changes in their relationships, behaviour and learning that suggest they may be in, or are moving towards, the severely impacting end of the continuum.

As key adults in a child or young person’s life, noticing these changes and acting to get things back on track can make an enormous difference to their mental health and improve their educational outcomes.

Development and context matters

When thinking about where a child or young person is on the continuum, it’s important to consider their age as a very wide range of emotions and behaviours are expected at different stages of development.

It’s also important to consider context and what’s going on in their life. Strong emotional and behavioural reactions are understandable and expected when someone is faced with difficult circumstances and should not necessarily be considered signs of a mental health condition.

Thoughts, emotions and behaviours are also influenced by many other factors that need to be considered, such as temperament, cultural background, and the presence of learning and developmental disabilities.

Determining whether a change in a child or young person can be explained by age and context or whether it’s the early signs that a mental health condition is developing, can be hard and may only become clear over time.

Remember, it’s not your role to diagnose or make conclusions about a child or young person’s state of mental health

That’s what mental health professionals do. The Mental Health Continuum is merely a guide to increase your understanding of mental health, assist in determining your level of concern and inform your actions.

You are doing your job by promoting positive mental health in your practice as an educator, monitoring children and young people who may require more attention and support during unsettled periods, and identifying and raising concerns for those who may need more targeted assistance by leadership, wellbeing teams or external mental health professionals.

  • BETLS observation tool

    BETLS is an acronym for behaviour, emotions, thoughts, learning and social relationships.

    This chart is a template for gathering and documenting information and observations about a child or young person.

    Observations should:

    • focus only on what you actually see and hear, rather than what you think about a child or young person’s behaviours, emotions and thoughts
    • take note of when, where and how often a child or young person is showing a particular behaviour or emotion
    • notice what makes the child or young person’s experience worse and what makes it better
    • record how long the behaviour or emotion occurs (for example, if you’re concerned about a child or young person’s outbursts, take note of how long they last)
    • notice what happens before and after the behaviour that is a concern
    • be recorded by different people and in different situations during the day.

    This template also provides a space to reflect on a child or young person’s experiences. It allows you to note their thoughts about a situation, and any other additional information that could be playing a role in their behaviour or mood.

    Download the BETLS observation tool [PDF, 196 KB]