Ninety three per cent of school leaders say that pupils bring more worries into school than they did five years ago and 97 per cent of primary school leaders say that people underestimate the mental health problems among school children. These are just two of the statistics from a survey of more than 1,100 primary and secondary school leaders carried out recently by Place2Be and the National Association of Head Teachers (NAHT).
It is not the only indication that mental health is a growing concern. The report Time to Deliver, published in November 2016, indicated the level of rising demand with, for example, referrals in Essex having doubled in a year from 3,000 to 7,000 open cases. The author, Emily Frith, also referred to evidence suggesting that young people are coming forward with more serious conditions and at a younger age.
Why the increase?
There are many possible reasons why the number of mental health concerns seem to be increasing. Dr Rona Tutt is a former special school headteacher and past president of the NAHT. She suggests that we are getting better at identifying the additional difficulties that pupils, such as those with SEND, might have.
However, Dr Tutt also acknowledges that there does appear to be a general, upward trend: “This could be due to a number of factors,” she told Headteacher Update. “More family structures that provide a less stable environment and the frenetic pace of life and pressure in schools is seen by many as a factor. Too much testing and the narrowing of the curriculum that goes with it doesn’t provide the right environment for children whose self-esteem may already be fragile or who would benefit from a more engaging and appropriate curriculum.”
Lis Carney-Haworth is headteacher at Torpoint Nursery and Infant School in Cornwall. She recognises that mental health has climbed up schools’ agendas: “I am not sure that things are worse than they ever were, just that awareness is greater. With secondary-aged school children there is a greater pressure around media and young people with Snapchat, Yellow etc which are newer issues with huge impact.”
Providing support
Alongside the perception by many that more of our pupils need support come worrying conclusions that schools are struggling to find the help they need. Fifty six per cent of the school leaders in the Place2Be/NAHT survey indicated that they find it difficult to obtain mental health services and more than one in five (22 per cent) who try to find support are unsuccessful.
Not only is it a question of getting a referral accepted, but also the length of time from referral to treatment. According to the Time to Deliver report, the median of waiting time for all providers is six months for a first appointment and nearly 10 months for the start of treatment.
“CAMHS in Cornwall is very difficult to access,” Ms Carney-Haworth added. “They see only the children who are at risk of harm to themselves and even then there is a long waiting list.”
In some cases, local authorities have channelled any money that they have into very specific programmes: “Recent finance given to local authorities for mental health has been spent on Thrive in Cornwall,” Ms Carney-Haworth continued. “Schools were unable to bid for any money directly. Thrive training was put in place for secondary schools and then key stage 2.
“We managed to get one person on the training as we asked directly. I am not criticising Thrive, but when we talk to social care or adoption services or Early Help Hub, before they will even talk about a child they will ask ‘have they been Thrived?’ as if this is the panacea to all mental health issues.”
The DfE responds
In January, in a speech given to the Charity Commission, prime minister Theresa May announced that improving mental health support was a key priority for the government.
Actions would include a review of children and young people’s mental health services and a Green Paper to include plans of how to improve services to schools. In addition, secondary schools will receive training from Mental Health First Aid England as part of a three-year programme.
It is not the first time that the government has shown some recognition that mental health is not all it should be in our schools. Time to Deliver was the report commissioned to comment on progress following the government’s investment of the £1.4 billion announced in 2015. The report is critical about the money not being ring-fenced and suggests that this is having a negative impact on the amount that actually reaches front-line services.
There is some criticism directed at schools too. Health services raise concerns about the difficulties they have in engaging with schools, particularly with changes to the education system, the reduced role of local authorities and the increased number of multi-academy trusts.
What can schools do?
Among the government pledges and training programmes, it is implied that schools can do more. Other materials being directed at schools suggest the same.
An online toolkit has been produced by the National Children’s Bureau – entitled A Whole School Framework for Emotional Wellbeing and Mental Health – which includes a step-by-step guide to developing capacity within a school. The materials suggest a four-stage approach to wellbeing and mental health:
- Identifying what’s in place already.
- Getting a shared understanding and commitment to change and development.
- Building relationships and developing practice.
- Implementation and evaluation.
Materials such as this provide useful ideas for making the most of what’s already available and perhaps developing it further, but they are not a solution to the epidemic that some schools are seeing.
Picking through the recommendations, we can see that much of the help that is being targeted towards children is dependent upon school staff. Rolling out universal training to secondary schools may help raise awareness but it is hardly a solution to finding the support that children and young people desperately need.
In the introduction to Time to Deliver, Normal Lamb MP points out: “Our research over the last year has uncovered a treatment gap, where specialist services are turning away one in four of the children referred to them by their GPs or teachers for treatment.”
It is hard to see how the government’s current plans will sufficiently address this treatment gap. In its absence, many schools have turned to employing and commissioning people and services of their own.
“We employ our own nurture and wellbeing lead who is fully trained in Theraplay and is a trained counsellor,” Ms Carney-Haworth said. “He is part of our staff but we also ‘hire’ him out to social care and other schools can buy-in his services. This means we can offer early intervention as soon as we or parents feel that it is necessary.”
However, this level of support, internally provided, is vulnerable: “Governments talk about supporting and recognising early intervention but the facts do not back this up,” Ms Carney-Haworth continued. “The new funding formula will leave us worse off. As a nursery and infant school, we have the lowest funding against our benchmarked schools.”
Mental health may be high now on schools’ agendas but with funding changes imminent it may just be one of those areas they feel forced to cut when the pressure is on. A treatment gap that no amount of school mobilisation will be able to plug.
- Suzanne O’Connell is a freelance education writer and former primary school headteacher.
Further information
- For further details on the Place2Be and NAHT survey, published to mark Children’s Mental Health Week 2017 in February, visit http://bit.ly/2kS9Thu
- Children and Young People’s Mental Health: Time to Deliver, Education Policy Institute, November 2016: http://bit.ly/2lfqS0O
- A Whole-School Framework for Emotional Wellbeing and Mental Health, National Children’s Bureau: http://bit.ly/2mfHpiY