Can schools combat mental health in children?

With 1 in 10 school aged children suffering mental health problems, Charlotte Lowe discusses a model she has developed and implemented to help tackle the issue.

This mental health model was developed to assist Lostock Hall Academy (LHA) in delivering both a whole-school approach to mental health, as well as offering more targeted interventions to children and young people (CYP).

The model is in line with recent guidance published from the Department for Education and focuses on two overlapping areas of concern for schools; emotional well-being and mental health.

The implementation of the model within this secondary school will be discussed based on the possibility of it being replicated in further schools. Given the rise in the number of CYP experiencing mental health problems, schools are under increased pressure to support their students.

Most schools recognise the need to support a student’s emotional health and well-being along with their learning. However, the use of clear terminology needs to exist across school, so there is a shared language whereby we distinguish between mental health, mental health problems and mental illness.

It is made up of different elements which aim to meet the emotional well-being and mental health needs of CYP.

Whole School Approach

It is essential for schools to provide a whole-school approach to mental health, to ensure the emotional well-being of students is everybody’s business. All staff need to take responsibility for identifying a CYP who may be struggling, and be clear on the processes if they’re concerned.

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Mental Health Policy

Every school needs a clear mental health policy in place, made available to all school staff, Governor’s, parents or carers. The mental health policy needs to exist alongside other policies in school, such as the anti-bullying and behaviour and exclusion policies.

The mental health policy at LHA details how the school promotes positive emotional well-being across school, as well as outlining the targeted support provided should a student experience mental distress.

It identifies key staff in school, external agencies offering support to CYP, and covers procedures and referral pathways to follow should any staff have concerns regarding a student.

Training all staff

The school counsellor has provided training to all staff to raise awareness of mental health, and highlight the school’s role in intervening early.

General mental health training was delivered to staff during inset days whereas training on more specific issues was carried out to a smaller group of staff members.

The training delivered to staff at LHA is in line with the Government’s recommendation that at least one staff member in each secondary school will receive Mental Health First Aid training (MHFA).

The role of the MHFA training is for school staff to identify those students experiencing mental health difficulties, and know what support is available and how to access this support.

Teachers are not mental health professionals, and they should not be expected to fulfil this role. Early intervention is vital, therefore this training provides huge benefits to school staff as they receive practical advice on how to deal with common mental health problems.

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Promoting positive emotional well-being

At LHA, positive emotional well-being runs throughout the school’s ethos, as all staff are involved in the promotion of well-being through the school environment.

In addition, positive emotional well-being is promoted through tasks such as assemblies, tutor time and PHSE lessons. Students are educated about mental health to enable them the knowledge of how to maintain positive emotional well-being.

We need students to become resilient and develop coping strategies to help them to deal with life’s challenges. The growth of social and emotional skills in CYP acts as a protective factor in preventing the development of mental health problems.

At LHA, we aim for a culture where talking about how we feel and seeking help when needed is the norm.

Single point of contact/mental health champion

It is essential for schools to have a designated mental health champion to act as a single point of contact with external agencies.

The mental health champion at LHA is the school counsellor, and she liaises with any service involved with a CYP’s emotional wellbeing, such as Children and Young People’s Mental Health Service (CYPMHS) or Children’s Social Care (CSC).

She ensures relevant school staff are informed of any emotional challenges a student is facing, meaning teachers can be mindful of the impact a CYP’s well-being may have on their academic performance.

Having a single point of contact to manage referrals to external agencies encourages transparent and consistent care for students, whilst also strengthening communication. Joint working between health and education is essential to effectively support CYP’s mental health, and this works well at LHA.

Once a student is referred to an external agency, the mental health champion maintains close contact regarding their treatment. This is to provide information where necessary to the agency, and to receive advice on how best to support the CYP in school.

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Parental support

Although schools are fundamental in support, it is essential for parents and carers to work alongside schools and external agencies to provide care for their child.

Parental support is invaluable, as they’re often first to highlight concerns in their children. Schools need to ensure parents know who to contact if they’re worried about their child.

At LHA, parents are encouraged to let their child’s form tutor know of any concerns, and a referral to the school counsellor for a mental health assessment will be made if considered necessary.

The school counsellor at LHA provides regular support to parents and carers in the form of meetings, telephone conversations or directing them to available support online.

This helps parents and carers understand their children’s difficulties. They often report feeling at a loss of how to help their child. Like their children, parents need to be educated about different mental health issues so they’re aware of the signs.

LHA has found providing support and guidance to parents can help to improve the effectiveness of specific interventions and approaches, as parents learn ways to support their child at home.

Assessments

At LHA, the mental health needs of CYP are assessed in school by making use of Routine Clinical Outcome Measures recommended by Children and Young People’s Improving Access to Psychotherapies (CYP-IAPT) programme, such as the Strengths and Difficulties Questionnaire (SDQ) and the Revised Children’s Anxiety and Depression Scale (RCDAS).

By carrying out these assessments in school, the school counsellor ensures only those suffering from a diagnosable mental health problem are referred to CYPMHS. Those experiencing mental health problems or lower level difficulties are effectively supported in school.

The school counsellor at LHA meets with all Looked After Children (LAC) to assess their emotional well-being and mental health. This is in line with reports which argue LAC are particularly vulnerable, and therefore more at risk of developing mental health problems.

Specialist support in school

Understandably, most schools cannot afford to employ a mental health specialist on a full-time basis. However, it is essential for students to have access to some specialist mental health support in school.

This could be in the form of a part-time school counsellor, or the introduction of new roles where a mental health specialist is responsible for a small cluster of schools.

Examples of current job titles which could potentially take on this role include CAMHS Practitioners, Low-Intensity IAPT Workers or Post Graduate Mental Health Workers (PGMHW). In LHA, the specialist support is provided by the school counsellor and this entails carrying out several roles.

Individual counselling sessions are offered to students, and therapeutic groups are available which focus on specific issues, such as loss and bereavement or self-esteem.

Specialist support is also made available to school staff in the form of advice and support.

Up-skilling the pastoral team

Most schools have an effective pastoral support team in place. The pastoral team are in an ideal position to support a CYP experiencing less serious difficulties, such as anger issues or low self-esteem.

At LHA, the school counsellor developed different resources in the form of booklets which staff use to support a CYP experiencing lower level mental health difficulties.

The work the pastoral team carry out with students can act as early intervention and help to prevent the development of diagnosable mental health problems. This helps reduce the number of students referred for school counselling or to external agencies for mental health support.

Peer mentoring

In previous years, the school counsellor developed a peer mentoring programme which involved training KS4 students to become peer mentors or ‘buddies’ to the younger students in school.

The training focused on promoting positive emotional well-being and supporting students experiencing less serious mental health problems.

Mentors were fully informed of what they should do if they were concerned about a student they were supporting, and supervision was provided weekly by the school counsellor.

The peer mentoring programme ran successfully for a couple of years but was put on hold last year. Given the success of the mentoring programme, we are hoping to re-establish it during the next academic year.

External agencies

The mental health champion is responsible for keeping up to date with the external services available to support a CYP in school. They need to be clear about the referral route into the service, and what support they can offer so that referrals can be made efficiently when required.

Staff well-being

Well-being in schools starts with the staff as they will be unable to effectively support a CYP experiencing mental distress if they are struggling themselves. Staff well-being should therefore be a priority of all schools.

The school counsellor at LHA provides counselling to any staff that may be experiencing mental health problems. This has proven beneficial for several staff.

Given the school counsellor’s interest in mindfulness, many of the staff seen for therapy benefitted from learning about this technique as a way of helping them to manage their stress levels.

Conclusion

Although this mental health model is not complete, and is continuously being developed, it can act as a guide for schools to meet CYP’s emotional well-being and mental health.

Along with the mentoring programme, LHA are also keen to develop the area of physical activity and well-being in school. Now schools have recognised the role they need to play in supporting CYP’s emotional well-being and mental health, numerous interventions are being trialled.

Many elements of this model are alike benefits featured in the Mental Health Services and School Links Project. The relationship between LHA and CYPMHS worked well because good knowledge and practice were constantly shared.

Given we are still unsure as to exactly what works, there is an urgent need for more research into evidence-based practices and approaches. However, huge variations in the level of support provided in schools exist, so mental health provision for CYP in schools needs to be made standard across the country.

One in ten school-aged children will have a diagnosable mental health problem at any time, with half of these mental health illnesses beginning before the age of sixteen.

Early intervention, the promotion of positive emotional well-being and mental health support therefore needs to be prioritised by all schools. This mental health model provides one example of how they can do so.

(Please note although reference is made throughout to the school counsellor, this was only for ease of understanding as she is qualified as a Cognitive Behavioural Therapist.)