Mental health: Prevention and intervention

Written by: Anna Cole | Published:
Image: iStock

The mental health challenge continues and schools are on the frontline. Anna Cole looks at the latest government policy, key challenges, recommended approaches, and signposts useful resources for schools

It is not uncommon for school leaders to tell me they have been forced to take severely traumatised pupils to A&E because they have been unable to get them into local mental health care.

They have had to resort to doing so because – alongside a greater prevalence of mental health problems in children and young people – specialist services have seen chronic under-investment.

This has happened over a long period of time, but particularly since 2010.

For example, we know that mental ill-health accounts for approximately 23 per cent of all NHS activity and 38 per cent of all illness for under-65s, but funding for mental health provision is equivalent to less than 12 per cent of NHS spending (The Five Year Forward View for Mental Health, Mental Health Taskforce, February 2016).

It is difficult to find the national figures for how much of this is spent on under-18s but we know that in 2016/17 some local NHS areas spent less than £10 a head on the mental health of children and young people in their communities (you can see if your area is one of them here http://bit.ly/2fjE3bT).

The Education Policy Institute (EPI) reported earlier this year that almost three quarters of CCGs (Clinical Commissioning Groups) failed to meet NHS England’s own benchmark for improving services (The Performance of the NHS in England in Transforming Children’s Mental Health Services, EPI, March 2017).

The reasons for rising mental health problems among children and young people are multiple and complex.

The fact that more people are coming forward to talk about their problems is no doubt in part a result of the reduced stigma surrounding mental health. As a nation we are talking about it more and this is undoubtedly a good thing.

Nor can we ignore the huge changes in technology, in particular the ubiquity of social media use among the young, and the way this is changing how children and young people communicate.

The role of schools and colleges

Schools and colleges have an absolutely crucial role to play in supporting children and young people with their personal development, welfare and safety.

The evidence shows that when schools and colleges promote the physical and mental health of students through a whole-school approach they help to create a virtuous circle. It reinforces attainment and achievement which, in turn, improves student wellbeing and enables students to thrive and achieve their full potential.

It is not, however, the role of schools to diagnose or treat mental health conditions. Diagnosis and treatment must be done by specialist professionals who are trained, qualified and clinically supervised. As such, we will continue to press for more and better-funded services.

Government plans

When Theresa May became prime minister she said that mental health was a personal and government priority. Back in March 2015 the Children and Young People’s Mental Health Taskforce had published Future in Mind, a national plan for the transformation of mental health services (see http://bit.ly/1wUwiQx) with government promising to invest £1.25 billion for mental health services up to 2020.

But £1.25 billion is not sufficient to close the “treatment gap”. It has been estimated that this extra funding will reduce the treatment gap from 1 in 4 to 1 in 3.

In January 2017, Ms May announced a forthcoming Green Paper on mental health and education and we await publication this autumn.
What will be in it? We know one key policy will be that by 2019 at least one member of staff in every secondary school should have received mental health first aid training.

The government has also promised to look at much-needed ways to strengthen the links between schools and the local NHS, improve specialist services, put more focus on prevention, and funding for trials of programmes that can be delivered in schools.

A whole-school approach

So what can schools and colleges do to educate students about mental health, resilience and wellbeing?

The evidence says that schools and colleges need to focus their energies on prevention as well as interventions through a whole-school approach.

This requires senior leaders to create and sustain an environment where students are able to build emotional resilience, develop self-confidence, aspiration and ambition, and learn how they can support their own wellbeing.

This approach covers all aspects of school or college life: ethos and environment, relationships, curriculum and teaching, development and wellbeing of staff, student voice, how you identify need and monitor impact, and work with parents or carers. There are some new and excellent resources available to help (see later).

In 2011, it was estimated that twice as many children and young people were experiencing emotional or behavioural problems compared with the 1970s (Layard 2011). In recent years the number of children and young people suffering from mental health problems has been rising and continues to rise at an alarming rate. We surveyed our members in February 2016 and asked about the prevalence of mental health problems in the preceding five years: 90 per cent reported a rise in their students experiencing anxiety or stress, 85 per cent reported greater depression, 81 per cent reported a rise in cyber-bullying, and 79 per cent reported greater numbers of students self-harming.

A whole-school framework

The National Children’s Bureau and the Partnership for WellBeing and Mental Health in Schools has created an online toolkit A Whole School Framework for Emotional Wellbeing and Mental Health. It recommends that schools:

  • Use a whole-school approach, which includes all parts of the school organisation working together.
  • Raise staff awareness about the widespread nature of mental health problems in children and young people, and the school’s responsibility to identify them and intervene early.
  • Teach social and emotional skills, and attitudes and values, through interactive methods and using well-trained and enthusiastic teachers.
  • Provide targeted work on social and emotional skill development for pupils in difficulty, including one-to-one and group work.
  • Take steps to understand the root causes of pupils’ bad behaviour

The toolkit outlines a four-stage approach, drawing on Professor Katherine Weare’s review of the evidence of what works in promoting social and emotional wellbeing and responding to mental health problems in schools.

Other resources

  • Promoting children and young people’s emotional health and wellbeing, Public Health England: Guidance for headteachers on eight principles informed by evidence and practitioner feedback about what works in promoting emotional health and wellbeing in schools and colleges: http://bit.ly/18OboaD
  • Public Health England and the Anna Freud National Centre for Children and Families has developed the Mental Health Toolkit for Schools. This toolkit is designed to raise awareness among staff about the range of tools available to help schools and colleges measure the wellbeing of students: http://bit.ly/2xgM8JV
  • The Time to Change campaign has free information, guidance and practical resources to help create a whole-school approach and strategic focus on mental health, as well as helping to facilitate networks for schools to support each other: http://bit.ly/1WzMihC


  • Anna Cole is parliamentary and inclusion specialist with the Association of School and College Leaders.

Further information

ASCL is running seminars on developing a whole-school approach to mental health and wellbeing on November 9 in Birmingham and November 28 in Manchester. For further information, email pd@ascl.org.uk


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