Turning mental health support in schools on its head

Written by: Andy Mellor | Published:
Image: Adobe Stock

As CAMHS delays continue to stack up, schools are taking it upon themselves to transform provision and safeguard children’s mental health and wellbeing, says Andy Mellor

Imagine a child in year 7 at your school – let’s call them Jesse – who has suddenly become anxious in lessons or has started falling out with their peers.

Teachers have been working with Jesse’s parents to address the issues behind this but there has been little change in the situation and Jesse is reluctant to access the school counselling services available. What is the next step?

A referral would often be made to the child and adolescent mental health services (CAMHS), but schools know it can be months before a pupil might get their first appointment – up to eight months in some areas according to a recent BBC Freedom of Information request (Triggle, 2021).

In my role as strategic lead for the Carnegie Centre of Excellence for Mental Health in Schools at Leeds Beckett University, I have seen headteachers in this situation, in schools small and large, located in leafy suburbs and areas of deprivation.

But I am also increasingly coming into contact with a growing number of senior school leaders who want to take a different tactic in meeting the emotional needs of their pupils.

Evidence-based early intervention

What these senior leaders want is to find evidence-based strategies that will help them intervene earlier to address children’s mental health and wellbeing. As part of this, they are looking at ways to make wellbeing an integral part of the education process.

A great example of this can be found at St Nicholas CE Primary School in Blackpool, where every child was given a red, amber and green cup which they were asked to bring with them into every lesson.

As different topics and activities took place in the lesson, the children would use the cups to reveal how they felt about what they were learning. So, they would hold out the red cup if they were completely confused, the amber one if they largely understood what was being covered, or the green one if they had grasped the subject and wanted to progress to the next one.

There was a huge benefit for teachers as they could see very easily who needed extra help. But the strategy also taught the children the art of self-assessment, which was an effective way to help them build confidence, resilience and self-esteem.

A scheme such as this could be incorporated quite simply into a typical lesson, helping to support the emotional wellbeing of children like Jesse and make them less likely to require specialist support further down the line when combined with other activities that build confidence, self-esteem and autonomy.

Working together

Effective early interventions aren’t always confined to the classroom alone, as one Swedishprogramme to improve children’s mental health clearly demonstrates.

Waiting lists for specialist mental health support have been significantly reduced for students in around 85% of schools in Sweden, where nurses and other professionals work with children and young people from inside the school gates.

One of the key elements of an approach like this is that working on-site, the teams have the opportunity to build relationships with the students in their care over time (Patalay et al, 2017).

While replicating this in the UK would require a complete overhaul of the way the school nursing system operates, the outcome could be fewer geographical disparities in available support and a more timely, personalised service that better meets the needs of children and young people.

Assessing services

One of the criticisms of the current mental health referral process often highlighted by practitioners and families is that it does not always capture the child’s voice as effectively as it might.

The input of the child can be critical to ensuring the right support is provided at the right time. One school has found a simple but highly effective way to gather pupils’ views and use them proactively to shape the pastoral services being provided.

Penistone Grammar in Sheffield asked pupils about their experience of using the school’s counselling services and were somewhat surprised to find that 28% of children felt they hadn’t benefited in any way.

Knowing this, the school was able to bring an art therapist in. This gave the children more choice, offering an alternative to the talking therapies they had access to, and the result was that the percentage of children who said they hadn’t benefited fell to 8%. It suggests significantly more children were getting the help they needed.


As schools continue to do all they can to help their pupils recover emotionally and academically from the pandemic, taking a fresh approach to mental health and wellbeing could make a world of difference to children such as Jesse and their families.

  • Andy Mellor is strategic lead for the Carnegie Centre of Excellence for Mental Health in Schools, which is an approved provider of senior mental health lead training. Andy is an experienced headteacher and was formerly president of the National Association of Head Teachers.

Further information & resources

  • Carnegie Centre of Excellence for Mental Health in Schools: https://bit.ly/3s5iLWW
  • Patalay et al: Mental health provision in schools: Approaches and interventions in 10 European countries, Global Mental Health, May 2017: https://bit.ly/3tLyiwl
  • Triggle: Children face 'agonising' waits for mental health care, BBC Online, September 2021: https://bbc.in/3tf8CXp

This material is protected by MA Education Limited copyright.
See Terms and Conditions.


Please view our Terms and Conditions before leaving a comment.

Change the CAPTCHA codeSpeak the CAPTCHA code
Sign up Headteacher update Bulletin
About Us

Headteacher Update is a magazine, website, podcast and regular ebulletin dedicated to the primary school leadership team. We tackle a wide range of leadership issues, offering best practice, case studies and in-depth information, advice and guidance. Headteacher Update magazine is distributed free to approximately 20,000 primary school headteachers.

Learn more about Headteacher update


Register to receive regular updates on primary education news delivered free to your inbox.