Obsessive compulsive disorder (OCD) affects 1.2% of the population in the UK alone. This equates to around 12 in every 1000 people, and as many as 130,000 young people.
OCD is an anxiety disorder where a person experiences unwanted and repeated thoughts, feelings or images (obsessions) and uses compulsive actions or behaviours (compulsions) to try and control the obsessive thoughts.
This compulsive behaviour only brings temporary relief and the child or young person may feel compelled to do them repeatedly. Young people may describe attempting to resist the rituals as causing their anxieties to intensify.
Whilst it has become increasingly common to joke about ‘being a bit OCD’ about cleanliness or tidying, in its most severe form, OCD is deeply distressing and frightening.
Many of the associated thoughts and feelings experienced by sufferers can engender strong feelings of shame, disgust and worthlessness. Sadly, a child or young person may obsess about those things which they hold most dear. For example, an activity they particularly enjoy or fears about those they most love.
Whilst these fears may not appear plausible or real to us, they can be a profound source of distress, especially if they focus on hurting others or humiliating themselves.
OCD Action
Experiencing mild obsessions and compulsions is a normal part of development for many children and young people during their lives. For example, having to organise their toys in a certain way, or checking that their clothes are straight.
Whilst this could be a normal reaction to stress or change, we need to be aware when a child or young person is having the same distressing thoughts and urges repeatedly, feeling unable to control them.
Giving a pupil permission to leave a stressful situation gives them the chance to self-regulate before becoming acutely distressed
| Obsessions | Compulsions |
| Fears of dirt, germs or contamination | Repeatedly checking things |
| Fears of acting on aggressive or violent thoughts | Repeatedly touching or tapping things |
| Thoughts of doing something forbidden | Checking rituals to make sure things are in the 'right place' and have not been moved |
| Feelings of discomfort if things aren't in the right place | Counting and re-doing things |
| Fear of losing important things | Counting and repeating words in your head |
| Needing to check if things are 'OK' | Frequently seeking reassurance |
Carefully planned time out strategies can be transforming. Giving a pupil permission to leave a stressful situation at the point their symptoms are beginning to escalate gives them the chance to self-regulate before becoming acutely distressed, reducing the time needed away from learning.
Supporting pupils to recognise this ‘tipping point’ helps build a sense of resilience. ‘I can have some control over my symptoms, rather than them controlling me.’
Small adjustments can make a real difference and significantly lower anxiety:
If a pupil is under the care of CAMHS, they may be eligible for ‘special consideration’ from the examination board at GCSE and A level. Liaise with your local CAMHS in advance and advise them of the new rules around this type of evidence.
Negotiate access to phone consultation if you are concerned about significant risk or harm arising from OCD. You should request a mental health assessment when:
Where symptoms may involve a child or young person’s faith or religious beliefs, specialist advice and support should be sought, as this is often highly distressing for the individual concerned.
Remember a child or young person may have worrying and intrusive thoughts, without them being acted upon. Assessing this type of risk and intention is complex and a specific mental health assessment is needed.
Teachers need to know how OCD impacts pupils individually, but pupils should be given the choice about what, how and whom information is shared with.
References and further reading
