Developing school mental health services

Over the summer the British Association for Counselling and Psychotherapy launched a campaign asking the Government to consider funding school and college counselling as part of the comprehensive spending review (CSR). This has since been debated in parliament, and an Early Day Motion (1) has been tabled and signed by 31 MPs.

UMHAN welcomes the long overdue focus on mental health support in schools, however we would urge the Government to consider this support in the wider context of contemporary mental health support mechanisms and of established systems within Further and Higher Education (HE). We do not support the statement in the Early Day Motion that counselling is the best way to address the problem of deteriorating mental health in children and emerging mental health conditions in young people. One of our fundamental beliefs is that mental health in education is best supported by a multidisciplinary team approach which recognises individual needs and complexity, and also protects non-specialist staff. Well trained teachers and support staff have an important part to play in ensuring schools are mentally healthy places for all, however, staff wellbeing is vital and boundaries should be clear. 

We would advocate for ring-fenced funding for schools to be able to offer a range of mental health support - this might include better training for staff, counselling, and better joined up working with CAMHS.

There are very few HE providers who rely completely on counselling as a one-size-fits all approach to mental health support for students, in recognition of the variety and complexity of presentations and needs, and practical steps necessary to maintain safe and healthy educational attainment. Counselling services have historically found themselves overwhelmed and educationally-focussed support services have had to broaden the scope of what constitutes mental health support to meet student needs; with a documented increase in mental health difficulties in children and young people there is no reason to think this would not be replicated within a school counselling system (2).

Within HE there are ongoing issues with a lack of consistent data collection and evidence-base for service improvement and development. This is urgently needed within all educational settings to ensure that non-clinical specialists in particular are supported to spend budgets wisely on services that meet the needs of their students. The Anna Freud Centre’s 5 Steps to Mental Health and Wellbeing (3) outlines how necessary it is to understand the mental health needs of pupils, to help plan provision and to measure the effectiveness of any interventions. Counselling meets a very particular form of need, requiring particular skills from pupils, and we believe that a wider range of interventions will be necessary in most education settings, particularly with the increase in eating disorders, self-harm and suicide in young people; this might include play or art therapy, trauma-informed approaches, reasonable adjustments or specialist mentoring. 

We also believe that for many children and young people being able to separate their learning world from discussing a distressing emotional world may be an important choice. So a stepped approach of understanding the limitations of a school-based service and how this links seamlessly to the other levels is key. 

A potential area for development in schools and colleges is Specialist Mental Health Mentoring. This is normally provided via Disabled Students’ Allowances for students in HE, and has proved very successful in improving the functioning, performance and experience of students with long term mental health conditions. This is one-to-one support aimed at meeting the individual needs of students and to promote strategies for independence and is focussed on removing barriers to learning (4). Children and young people with long term mental health conditions are protected by the Equality Act and should be able to access adjustments and support through Education and Health Care Plans and we would strongly recommend that specialist mental health support, such as mentoring, is provided in this way. 

The recent Arriving At Thriving Report (5) has recommended that a new system is created to support disabled people from the classroom to the workplace, removing disadvantage and ensuring access to education. Our experience over many years shows us that this lack of joined-up approach in preparation for the next phase of a young person’s life leads to delay in access to support for Higher Education students, whether this applying for Disabled Students’ Allowances or concern about disclosing to a university in case it negatively affects an offer. The negative consequences of this involve further harm to mental health due to reduced accessibility to work/education, rather than progress being made based on the person’s actual ability.

In this way the role of SEN staff should not be underestimated in managing mental health in education. Additionally, some children’s mental health is likely to be negatively affected by slow diagnosis of specific learning difficulties or autism - more development is needed in identification of these issues in children and young people, alongside more resources in the NHS services which diagnose and support them. 

Joined up working through the developing Mental Health Support Teams within the NHS promise to provide early intervention and shorten waiting times; we believe this will be beneficial for the most unwell students, however, timescales appear slow. This development focuses on treatment. Experiences in HE show that responding to disabling effects of mental health difficulties, and dealing with features of education which most negatively affect students’ mental health, are better addressed through individual adjustments or more inclusive practice - this includes teaching and learning (such as assessment) but also excessive administration and rigid processes. 

We agree with Trauma Informed Schools UK that “the value of well being has to start at the very top, with organisations such as DFE, Ofsted and the Regional Schools Commissioners balancing the scales between outcomes (test scores) and emotional wellbeing”. (6). 

We would add that the education system for school-aged children should be radically reformed to: accommodate children affected by trauma, abuse and distress; prevent re-traumatisation, anxiety and further damage to self-esteem; optimise opportunities for those most in need of help.  This will reduce the manifestation of longer-term mental health problems, and will require greater consideration of the breadth and range of tools available to do so. 

References:

Early Day Motion 943 - Funding for school counselling services https://edm.parliament.uk/early-day-motion/57498/funding-for-school-counselling-services (accessed 9/11/20)

Young Minds Mental Health Statistics https://youngminds.org.uk/about-us/media-centre/mental-health-stats/(accessed 9/11/20)

The Anna Freud National Centre for Children and Families - 5 Steps to Mental Health and Wellbeing: A Framework for Schools and Colleges https://www.annafreud.org/schools-and-colleges/5-steps-to-mental-health-and-wellbeing/(accessed 9/11/20)

University Mentoring Organisation “The Role and Impact of Specialist Mental Health Mentoring On Students in UK Higher Education Institutes” https://umo.london/whitepaper.html (accessed 9/11/20)

Higher education Commission and Policy Connect “Arriving at Thriving - Learning From Disabled Students to Ensure Access for All” https://www.policyconnect.org.uk/research/arriving-thriving-learning-disabled-students-ensure-access-all (accessed 9/11/20)

Trauma Informed Schools - Our Mission https://www.traumainformedschools.co.uk/ (accessed 9/11/20)