SEMH meaning – exactly what does SEMH mean?
SEMH stands for social, emotional, and mental health, a rather broad term used to describe the range of difficulties that children and young people may have with managing their emotions and behaviours.
SEMH is a category of special educational needs (SEN). The term SEMH was created by SEN Code of Practice (2014) to replace SEBD (Social Emotional Behaviour Difficulties) and EBD (Emotional and Behaviour Difficulties) purposefully dropping the word ‘behaviour’, in an attempt to emphasise that behaviour is only ever a way of communicating the needs and recognising the link between behaviour and mental health difficulties.
SEMH can present in a number of ways such as low self-esteem and lack of confidence, difficulty in forming and sustaining healthy relationships, anxiety, depression, dysregulated emotional states and behaviours that can be challenging to respond to and manage. SEMH is one of the four main categories of the Special Educational Needs and Disabilities (SEND) SEND Code of Practice and in education relates to the support a child or young person might need in managing their emotions, behaviours and mental wellbeing.
Social, emotional and mental health difficulties (SEMHD)
Children with social, emotional and mental health difficulties (SEMHD) will often feel anxious and misunderstood. This summary of presenting behaviours and areas of difficulty is by no means full and conclusive but covers a wide range of the SEMHD children experience, to support identification, provision mapping and appropriate intervention.
Social
- Making, sustaining and managing friendships
- Relationships with adults
- Playground difficulties – controlling, avoiding, overwhelm in play situations
- Conflict resolution
- Issues around bullying
- Understanding social rules or boundaries
- Reading social situations or understanding social cues
- Attention, hyperactivity, impulsivity – ADHD type behaviours prevent access to learning and social contexts
- Learning context – difficulties learning in a social classroom environment
Emotional
- Identifying and managing heightened or dysregulated emotions
- Excessive worrying which is not easy to resolve
- Persistent sadness and withdrawal which does not resolve with care and encouragement
- Dysregulated, oppositional or disruptive behaviour (may include frustration, anger, verbal and physical aggression)
- ‘Emotional School Based Avoidance’ (EBSA) – school based fear
- Emotional triggered responses relating to trauma or early childhood experiences
- Low self-esteem or poor sense of self – learning focussed or self-perception (including masking of feelings or needs)
- Masking of feelings and unable to seek support
- Bereavement and loss
- Attachment or relationship difficulties (could be clingy, needing constant reassurance or avoidant, rejecting or sabotaging of relationships)
- Developmental trauma
Mental health
- Anxiety
- Developmental trauma
- Withdrawn, persistently sad or depressed
- Panic attacks, phobias, fear-based responses
- Obsessional compulsive disorder (OCD)
- Diagnosis of neurodiverse conditions (ADD, ADHD, ASC) attachment disorder, pervasive development disorder, an anxiety disorder, or, more rarely, schizophrenia or bipolar.
- Self-harm
- Conduct difficulties, challenging, distressed or dysregulated behaviours
- Difficulties around eating, eating disorders, or restrictive eating
- Situational mutism
- Sexually risky behaviour
- Suicidal ideation
Children and young people may experience a wide range of social and emotional difficulties which manifest themselves in many ways… These may include becoming withdrawn or isolated, as well as displaying challenging, disruptive or disturbing behaviour.
What are the signs of SEMH?
Not all children will display the same behaviours, but these are some common ways SEMH can manifest:
- Dysregulated, distressed, disruptive, challenging or uncooperative behaviour
- Unable to make and/or maintain friendships
- Frustration, anger and verbal and physical aggression
- Withdrawn, isolated or emotionally detached
- Difficulty following rules or routines
- Mood swings and emotional outbursts with unpredictable changes to their personality
- Anxiety, low self-worth, unaccepting of praise
- Self-harm or has self-sabotaging behaviour
- Eating issues or eating disorder
- Lethargy or apathy
- Restlessness, over-activity and impulsivity
- Selective mutism
- Unable to make choices, avoids tasks
- Avoiding risks, or risk-taking behaviour
- Displays disproportionate reactions to situations
- Poor awareness of personal space, lacking in inhibitions
- Lack of empathy
- Poor personal care
- Emotional school-based avoidance – school fear
- Lacks capacity to understand cause and effect and accept consequences
- Stealing, telling untruths or misleading behaviours
SEMHD can have a profound impact on a child’s engagement in learning, academic success and overall wellbeing. These needs may affect a child’s ability to concentrate, regulate their emotions, form positive relationships with peers and adults, and feel safe or confident in the school environment. Without appropriate support, SEMHD can lead to absences, behavioural issues and a lack of self-esteem, and long-term consequences for both educational outcomes and mental health.
