How schools can plug gaps in NHS mental health services

1st July 2016 at 00:00
Headteachers increasingly turning to pupil wellbeing programmes to support students ‘at breaking point’

Schools are facing a mental health crisis as the pressure on pupils grows and funding for services to support them falls.

Some leaders are now turning to practices that would previously have been regarded as “hippy”, as they attempt to plug gaps in NHS provision and protect pupil wellbeing.

Heads say that investment in preventative measures early on can pay off, even when budgets are stretched, as later problems can then be avoided.

Viking Primary School in Northolt, north London, buys in the services of children’s mental health charity Place2Be, which has run one-to-one counselling sessions, drop-ins, and self-esteem and conflict-resolution lessons.

“People are starting to realise you need a good mental health to learn well,” the primary’s head, Jamie Maloy, said. “It’s important to sort out the problems that may not have a name or diagnosis, but need sufficient help. It is best to catch these things early.”

From September, a teaching assistant at Viking will be taken out of the classroom and pupil wellbeing will become her sole focus. She will be based in a new sensory room for students, with comfortable chairs, calming lights and music.

“A few years ago, that would have been seen as hippy and ‘out there’, but now it’s becoming common practice,” Mr Maloy said. “We are hoping that we can prevent wasted time in class having to deal with these children with problems and we will get more learning done.”

The government’s former mental health tsar, Natasha Devon, has noticed a “growing trend” of schools buying in programmes to support young people “at breaking point”. But there has also been confusion over which external services to use.

“It is important that they have some clarity about what’s the best choice for their school,” Ms Devon said (see box, below).

What is clear is the growth in pupil mental health problems. In 2014, school-leadership support organisation The Key surveyed more than 1,100 heads and found that more than three-quarters had to deal with pupil mental health issues. In January, children’s commissioner for England, Anne Longfield, called for all schools to provide counselling for pupils. But the recognition that more needs to be done has come just as funding for Child and Adolescent Mental Health Services, which should be supporting schools, is cut.

Access denied

In May, a survey by the children’s mental health charity the Anna Freud Centre found that teachers believed that stretched NHS services were now a bigger barrier to supporting pupils with mental health problems than the stigma attached to the conditions.

And last year, the Association of School and College Leaders warned that mental health services for pupils were now so poor that some schools had to resort to dialling 999 to get treatment.

Mr Maloy wants to prevent problems getting to that stage. Next year, all staff in his school will be trained in mindfulness in order to help teachers and pupils.

Other schools are using mindfulness to combat exam stress (see box, right) and Ed Vainker, head at Reach Academy Feltham, will ensure all of his pupils – from ages 4 to 18 – are taught mindfulness in class over the next 12 months.

“There will be an opportunity for pupils to practise every day,” he said. And despite coping with an overstretched budget, Mr Vainker has also invested in training staff about attachment theory – which suggests that children who fail to make secure attachments with their main caregiver within their first three years can make them particularly disruptive.

“We want to help teachers see themselves having agency in this and to have the opportunity to have healing relationships with young people,” he said.

Ms Devon cautions schools against adopting a one-size-fits-all approach to mental health. “It does seem to be common practice now to buy something else in,” she said. “But in some schools, mindfulness just won’t work.”

The former DfE children’s mental health champion is currently trialling a programme in schools to see if a series of 10-minute exercises on themes such as sleep, food and social media can make a difference.

Ms Devon believes that heads should make their own decisions on what works best for their pupils through trial and error.

“It is not just about the intervention,” she said. “It is about the person who carries it out. It can also have a detrimental impact if you buy in the wrong service.

“It is really important that wellbeing is part of the ethos and fabric of the school.”


‘GCSEs increase the pressure’

The pressure on young people will grow as a result of revised GCSEs that will be taken next summer, according to Patsy Kane, an executive headteacher in Manchester.

Students who started their GCSEs in September will no longer do controlled assessments or take modular courses; instead, they will be assessed at the end of two years.

“The shift to end-of-year exams will increase pressures,” she says. “It will become all or nothing for students at the end of term.”

Young people now face “a lot of uncertainty”, when they could have been reassured by coursework already submitted, Ms Kane adds.

At her two girls’ schools – Whalley Range High and Levenshulme High – students are already taught about stress relief, having plenty of sleep and staying hydrated in the run-up to exam time. Two extra counselling days a week have also been introduced.

The head is now planning to bring mindfulness in to the school. “We think a number of pupils can benefit from positive teaching and the importance of learning to switch off,” she said.

How to approach pupil wellbeing programmes

Natasha Devon’s top tips for heads on inviting pupil wellbeing programmes into their schools

1 Don’t Google: companies and charities that can afford it pay to get to the top of Google’s ranking. This doesn’t make them the best or most suitable for your pupils, just the richest.

2 Talk to other teachers: for a reliable review, ask those in local schools about what they have used and how well it worked.

3 Ask for a trial: any reputable programme will agree to a trial period to check how well the intervention resonates with pupils. The programme provider should understand that this is a big commitment for your school.

4 Go for evidence-based interventions: don’t be afraid to ask exactly how the programme measures its efficacy. For example, at Self-Esteem Team, we sample a random cross-section of 400 pupils every academic year and measure how well our classes have increased their understanding of mental health issues, their ability to talk about them and confidence to seek help if they need it.

There’s no point in just asking pupils if they enjoyed the lesson. Beware of programmes that only have quotes as proof of their efficacy; testimonials don’t always give a reliable picture.

5 Having said that, it is all about relationships: the only thing psychologists across the profession agree on is that your chances of recovering from a mental illness increase dramatically if you have a good relationship with/trust in your therapist. The same applies with classroom or school-based interventions. The pupil must have a good relationship with – and be engaged with – the person delivering the programme, otherwise it just won’t work.

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