Is targeted intervention as part of a whole school approach to mental wellbeing the answer?

In the last three years the likelihood of children having a mental health difficulty has increased by 50% and it is reported that five children in a classroom of 30 are likely to have a mental health problem.¹

Research from the Centre of Mental Health shows that, in England alone, 1.5 million children and young people under 18 will need new or additional mental health support as a direct consequence of the coronavirus pandemic.² This post-covid picture is alarming at 77% rise in severe mental ill-health but the reality is that even before the pandemic, we were seeing significant trends towards higher numbers of children with mental health needs and unhappiness.

The most recent Good Childhood Report found that: “Ten years of data from the Understanding Society survey shows that, even before Covid-19, there had been a worrying decline in children’s happiness with their lives as a whole, their friends, their school and their appearance, which needs to be understood and targeted.³

The mental health landscape is complex and many children have been exposed to greater factors as a direct result of the pandemic such as isolation throughout lockdown. But for many, factors such as poverty, adverse childhood experiences (ACES), the boom in social media, the education postcode lottery, austerity and the lack of sufficient services, were already on the rise and have been exacerbated in recent times.

We know from research that having a whole school approach and a culture of wellbeing is crucial for children’s mental health and having access in schools to a rich emotional literacy curriculum is a core part of this.

In the recent House of Commons report it was highlighted that:

“A whole school approach involves the universal and continuous promotion of good mental health across all parts of the school including the curriculum, the school leadership and staff-student relationships. It is not only about preventing mental ill health but about the promotion of positive mental health and wellbeing being integrated into a normal school day, while reducing stigma and encouraging openness around mental health.”

The report goes on to state how schools are pivotal as the place where children spend a great deal of their time and where:

“… the availability of mental health and wellbeing support in schools can have a profound impact on a child or young person.”

A review cited in the House of Commons report and conducted by the Early Intervention Foundation (EIF) highlighted that in 35 systematic reviews and 98 primary studies over the last 10 years that school-based universal interventions “have good evidence of enhancing young people’s social and emotional skills and reducing symptoms of depression and anxiety.”

It therefore needs to be highlighted that there is growing evidence that schools can make a significant difference in the delivery of not only universal provision, but also through well planned, structured and targeted intervention, not only in identifying need, but in providing programmes of qualitative intervention. “… where young people can build resilience, work through their feelings, learn to cope with the stresses of growing up.”¹

Having a responsive, proactive and preventative approach of early intervention is vital, and having adults who are valued, renumerated fairly for the work they do and supported in their role to ensure their own wellbeing, is essential and an investment for the health and wellbeing of our children.

As Anna Freud National Centre for Children and Families, Mentally Health Schools: Whole-school approach report cites: “A whole school approach to mental health should also involve a targeted element, by making sure that teachers and other staff can recognise pupils with emerging mental health needs and provide early support to these pupils.4

The government agenda to create and train Senior Mental Health Leads (SMHLs) and to roll out a programme of Mental Health Support Teams (MHSTs) that provide a role in intervention and signposting as part of the strategic plan is underway.

Alongside this is the need for recognition of the role pastoral staff within schools play.

They already do much of the early intervention and very often act as a holding place for children when there is a lack of access to wider services. There is an opportunity to enhance this with higher levels of in-school training around therapeutic approaches and intervention programmes rather than an overreliance on external counsellors.

In-school staff can have a greater reach and already have the working alliance and relationship with the children on a day-by-day basis and with the right support and value given to them, can do significant work akin to that of trained therapists. The government 2017 green paper Transforming children and young people’s mental health provision highlights:5

“There is evidence that appropriately-trained and supported staff such as teachers, school nurses, counsellors, and teaching assistants can achieve results comparable to those achieved by trained therapists in delivering a number of interventions addressing mild to moderate mental health problems.”

Whilst schools and SMHLs need to know when to refer on to wider services, they also require faith that there are services with the capacity to respond to higher levels of mental health need.

There needs to be a greater focus on the role of SMHLs and pastoral staff in schools who do incredible work in supporting children’s wellbeing and protecting against long term mental ill-health. This is often overlooked and referrals are made to external services when there is evidence to show that there is great work being done, especially with trauma informed and attachment aware schools and staff.

With greater funding, training, supervision and support within schools, early intervention provided by trained and supported pastoral staff would make an even bigger difference as part of a whole system graduated approach. Greater recognition and focus whilst ensuring schools are well supported, funded and revered for the central role they play is an opportunity that we need to embrace.

Measures of children’s happiness (aged 10 to 15) showing significant change in UK in 2018-19 compared to 2009-10 ³
Measures of children’s happiness

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