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A plan for child mental health

Evidence of a mental health crisis among young people is overwhelming. But slowly and surely we are beginning to take action, says Anna Feuchtwang

When, at the beginning of January, the NHS Long Term Plan announced that an extra £2.3 billion will be spent on mental health care every year, you could sense a collective sigh of relief from teachers.

School staff know all too well that there is a rising tide of children and young people with mental health issues. They see the pupils falling behind; they see the absences; they see the distress. And they see at first hand the difficulty in accessing professional help beyond the school gates.

The discrepancy between the numbers needing help and the capacity of children and young people’s mental health services in the community is hard to ignore.

The Children’s Commissioner for England recently estimated that of the 340,000 children referred to child and adolescent mental health services in 2017/18, more than two-thirds did not receive treatment within the year.

One of the reasons for sky-high thresholds for accessing services is the sheer number of children involved. When the National Children’s Bureau (NCB) analysed data on more than 10,000 children, we found that one in four teenage girls, and one in 10 boys, experienced symptoms of depression.

This picture was confirmed by the prevalence study published by NHS Digital late last year. It found one in eight children aged five to 19 had at least one mental health disorder.

In this climate, schools have, by necessity, had to develop expertise in mental health and wellbeing themselves. We have been overwhelmed by the positive response to the Wellbeing Award for Schools that NCB developed with Optimus Education. Launched in September 2017, 42 schools have now achieved the award, and more than 700 are working towards it. The award recognises schools’ work to develop the provision and practice that can boost emotional wellbeing in the whole school community so that pupils, staff and parents alike can benefit.

When the first school to receive the award was featured on the BBC, it was notable that parents were among the first to praise how the school’s approach had helped. The reason is that the award, as well as supporting teachers and pupils, encourages schools to equip parents with the tools and understanding to deal with their children’s mental health needs too.

Having a consistent approach at school and home can be extremely productive, as one mother put it: “It helped me not to react as quick and think about the way I’m dealing with the kids, rather than going off at the deep end.”

The whole-school ethos at the core of the award is based on a framework developed by the Partnership for Wellbeing and Mental Health in Schools. The partnership’s framework is freely available, alongside a self-assessment tool that allows school leaders to evaluate the strength of the teaching, systems and policies that should promote pupil wellbeing.

Now, perhaps more than ever, is a time when self-reflection by schools is needed. Over the coming years, headteachers will have the chance to embrace a host of new initiatives with the potential to improve child mental health.

First to arrive will be guidance on statutory relationships and sex education and the new health curriculum. A mandatory health curriculum is something new for schools and it is expected to include a strong focus on developing confidence, resilience and self-respect.

Following that there will be incentives for every school to have a designated mental health lead, coordinating their school’s collective work to support wellbeing. The designated lead will be able to draw on help from mental health support teams, whose job it will be to act as a bridge between schools and CAMHS.

The plan is that the support teams will offer individual and group help to young people with mild to moderate mental health issues including anxiety, low mood and behavioural difficulties. Trailblazer areas are soon to be announced in order to pilot how best to organise this new way of working.

With the NHS poised to deliver on its side of the bargain, is it too much to suppose we have turned a corner, with mental health finally achieving greater parity with physical health in the eyes of policy-makers?

Schools, better than most, understand the scale of the problem. We now have commitments to meet the challenge. Over the next few years these pieces of the jigsaw must come together.

  • Anna Feuchtwang is chief executive of the National Children’s Bureau.

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