We must fix the fault line in mental health provision

Mental health provision in schools needs drastic action – the government’s proposals do not come close
18th August 2018, 6:04pm

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We must fix the fault line in mental health provision

https://www.tes.com/magazine/archive/we-must-fix-fault-line-mental-health-provision
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As I’m sure you’ll be aware, there have already been many policy announcements this summer. One of the most important has been the government’s response to the Transforming Children and Young People’s Mental Health Green Paper, which gives indications of the content of the upcoming White Paper.

Schools NorthEast, where I am director, welcomes the policy focus on this area and will work with schools and local partners in the NHS to make sure we benefit as much as possible from the opportunities the proposals present.

There are a couple of areas we take issue with in this response, however. Ministers reject the claim that the designated ”mental health lead” role places additional burdens on school staff, pointing out that schools already spend a great deal of time grappling with mental health issues.

I think this argument fails to appreciate the complexity of the role. Responding to an entire school’s mental health needs, if done properly, is a multifaceted, time-intensive role that deserves to be properly resourced. Moreover, it cannot realistically be performed by one individual. All staff from NQTs to heads to governors and trustees need to be dialled into this agenda.

The response is also problematic in its approach to the “trailblazer areas” intended to pilot the proposals. Much criticism has been levelled at the relatively unambitious timescales, but the way the bidding process is set up should also concern us.

Apparently, ministers expect “the education sector to have a central role in the application process and in designing and leading delivery”. Yet if we truly wanted educators to be involved in the co-production of applications the given timeframe could hardly be less conducive.

Bidding kicked off during the summer holidays, when most school leaders will be taking a well-deserved break, and concludes in mid-September. Schools North East has offered to support bidders in the North East, which we hope will bring some education expertise to local bids.

These are a few of the areas where the government’s response leaves much to be desired, yet I think there is an even more important “big picture” critique.

First, these proposals will be introduced into a child mental health care system that the Care Quality Commission recently characterised as being fraught by “fragmentation at every point from planning and commissioning to oversight and regulation”. It went on to say “these obstacles prevent those working at a local and regional level from realising the vision of joined-up, personalised care and support.” The Green Paper doesn’t address this fragmentation. The secretary of state must take the opportunity to do so in the upcoming 10-year plan for the NHS.

Second, there is little acknowledgement of the causes of poor mental health among children, particularly where it is affected by the political direction of travel toward a high-stakes, high autonomy and high accountability education system.

This has, for instance, undoubtedly increased stress from exam pressure and the Education Committee found evidence that the narrowing curriculum alienates less academically inclined children. MPs couldn’t be more plain when they write: [Pupils] cited that the relentless focus on Ebacc subjects did not suit all of them and led to low self-esteem and unhappiness”.

The political direction has also strengthened incentives for leaders to behave in a way that may boost their performance as a school or group of schools, but is contrary to the wellbeing of pupils. Schools NorthEast has seen data from a local authority in which two schools undertook around 1,500 per cent more fixed-period exclusions in Autumn 2017 than they did in Autumn 2016.

It is important that school leaders have a range of options to deal with bad behaviour and exclusions are sometimes necessary, yet it is difficult to understand why they are so much more necessary than they were previously. It scarcely needs to be said that if exclusions are not carefully applied a child’s removal from school can disrupt their education and impact on their mental health.

Finally, there is a lack of joined-up thinking between child and parental mental health services. From Adverse Childhood Experiences (ACEs) research, we know there is a direct link between childhood trauma and the onset of chronic disease, violent behaviour, depression and suicide.

Traumatic experiences such as feeling unloved by your family, domestic violence and parental substance abuse all increase this risk. Yet adult mental health services are not closely connected to children’s services in the way they should be.

There is much more that could be said on this: on the long-term failure to embed mental health awareness and evidence-based mental health interventions into our education system or to engage young people themselves in designing the mental health structures that affect them.

The Green Paper doesn’t fully address the glaring holes in child mental health provision. There is another upcoming opportunity, with the 10-year plan for the NHS likely to be delivered by the time of the Autumn budget. The government must seize this opportunity for the benefit of children nationwide.

Mike Parker is the director of Schools NorthEast

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