It’s an issue with which we are sadly all too familiar: schools are often not just about education. Society lays all its ills at their door. Heads and teachers are expected not only to educate children but also to deal with their social, emotional and health problems.
Doctors have long known that many of the things that determine a person’s health are not related to strictly “medical” factors. If someone is out of work, lonely and living in poorly ventilated, damp housing, then they are much more likely to get sick than someone with a good job, a nice house and a strong social network. This is why male life expectancy in a deprived area such as Blackpool is nearly a decade shorter than in a more affluent area like East Dorset.
It won’t come as a revelation to teachers that much of the education gap is determined by things that happen outside the classroom – the accommodation pupils live in, the stability of the home environment and their family’s income. To put it simply: children do not and cannot perform well at school if they have respiratory illnesses such as asthma, are worried about a chaotic home life or have dental problems – the last of which is one of the main causes of school absences.
To address the “social determinants of health”, some innovative GPs have started doing “social prescribing”. Rather than just handing out conventional drugs and treatments, they put certain patients in touch with community groups – ranging from dance classes and knitting groups to cookery clubs – to help them break free of emotional isolation and live healthier lives.
And some schools are doing the same thing to address what you could call the “social determinants of education” – signposting families to services and organisations that will help ensure that when their children enter the classroom, they are physically and mentally in a fit state to learn.
Investing in services
One such school is Reach Academy in Feltham, Middlesex. It provides a range of non-educational services to its children and their families and has ambitious plans to set up a centre bringing together service providers such as GPs, health visitors and midwives on an adjacent site.
It is in a fortunate position as a free school of starting from scratch with no legacy financial issues, but investment in these wraparound services does have the potential to save money in the long term as well as to deliver good academic results.
“It’s a cliché,” says co-founder and principal Ed Vainker, “but we think that early intervention definitely pays – it yields a financial return.”
But reimagining school as a multi-service community “hub” along the lines envisaged by Reach isn’t going to be simple. Some GPs have redesigned their practices to create open-plan, shared spaces where families can access a range of services and different professionals can intermingle and exchange intelligence. This doesn’t sit particularly easily with school’s safeguarding responsibilities – the need to closely control who accesses the school site and how they move around it. Likewise, strict data-protection regulations will be a tricky challenge to navigate when it comes to sharing information about pupils with other agencies.
In these cash-strapped, overworked times, many will shake their heads and say no, we just can’t do all of this. But to understand children fully, to support them fully, schools need the whole picture. Unfortunately, currently, no one but the child can paint that.
Despite the efforts of the pioneers, schools can’t do it on their own. Only central government can force the integration of these services. No one else can do it on the scale required. Education must work not only with health but with the justice department, too. If they don’t, we condemn each troubled child to be a self-advocate, to carry around their profile and present it to all the individual support people, to be in charge of their own route, to have the ability to step outside of their own situation and conduct their own care. And that can never be right.