How many school-age children are taking anti-depressants? Results of a Freedom of Information request published in The Guardian suggest nearly 170,000 children in England were prescribed drugs like Fluoxetine (also known as Prozac) to treat depression and anxiety between April 2015 and June 2016, an increase of almost 12 per cent since the previous year (Number of under-18s on antidepressants in England rises by 12%, Guardian, June 2017).
Medicating so many school-age children is worrying for a number of reasons. Putting aside doubt over whether such drugs are actually effective on young people, the increasing numbers of doctors reaching for their prescription pads is likely to be explained, at least in part, by the scant availability of so-called talking therapies for children.
In a National Children’s Bureau (NCB) survey last year, nearly two-thirds of school leaders said they had difficulty in obtaining mental health care from local services in their area for students who need more specialist support (for more, see http://bit.ly/2sQkAsd).
The simple fact is that children’s emotional wellbeing is under fire: exam pressure; fear for the future in an uncertain economy; anxiety over body image in a hyper-sexualised media environment.
And then there’s the internet. Alongside the tremendous opportunities offered online, come serious threats. Cyber-bullying is a growing concern. No longer can you leave the bully behind at the school gates. They follow you home through your SmartPhone, tablet and laptop.
In this climate schools are waking up to the fact that their contribution to pupils’ emotional welfare is vital if the numbers of children needing support in crisis – and quite possibly prescription drugs too – is not to rise further.
The NCB is currently developing a Wellbeing Award for Schools with Optimus Education. This new award builds on years of research work we have undertaken on child mental health, and will recognise schools that embed a culture which values the happiness and emotional welfare of all its pupils.
These are some of the principles that we’ve seen can help schools promote good mental health:
A shared understanding on mental health
A shared understanding of the language you use in school about social and emotional wellbeing and mental health problems will help you have clear and consistent conversations internally with staff and students and with external services, parents and carers.
“Social and emotional wellbeing” refers to a state of positive mental health. It involves optimism, confidence, happiness, and self-worth. While “mental health problems” refer to the wide range of mental health challenges, conditions and illnesses that can beset both pupils and staff.
Adopt a whole-school approach
Both the Department for Education and Ofsted have supported the whole-school approach, stressing that promoting good mental health is the responsibility of all members of a school community: its staff and governors, parents and pupils, and partner organisations beyond the school gates.
Get wellbeing right
Start with a positive focus on wellbeing for everyone at school and show that exam results aren’t the only measure of success. This should begin by ensuring that both the school and classroom climate is supportive and inclusive – and this should extend to the staff too, ensuring they have someone to turn too when stress gets too much.
Prioritise staff development
Staff should be aware of the risk factors around child mental health, often linked to the background a child grows up in. Those who come from disadvantaged groups, like looked-after children, or from families experiencing challenges such as poverty or relationship breakdown, will be particularly susceptible.
Tighten school policies
Policies set out the responsibilities of everyone in the school and the range of acceptable and unacceptable behaviour and their consequences, understood clearly by all, and consistently applied. Particularly key to mental health and wellbeing are the school’s policies and practice relating to behaviour, diversity, and the challenging of prejudice and bullying.
Targeted responses and specialist pathways
Some pupils will have difficulties and require more intense work on developing social and emotional skills than their peers. They may benefit from working in a small therapeutic group on a particular skill or theme. Such targeted and skills-based work has been shown to have a clear and positive impact on a range of problems, including depression and anxiety, and conduct disorders.
A pupil whose problems are greater than in-school support can meet can be referred to a GP and thence possibly to CAMHS. The school should have mapped a clear pathway to help from specialists, with systems and processes for making decisions, and commit to anchor support within the school where possible.
Take the long view
Building a mental health and wellbeing plan for your school is a commitment for the long term. Short initiatives and targeted interventions have their place, but mental health should be something that is reflected in every aspect of school life, day-in, day-out.
- Anna Feuchtwang is chief executive of the National Children’s Bureau. Visit www.ncb.org.uk
Further information
Register for the Wellbeing Award for Schools at http://www.optimus-education.com/services/awards/wellbeing-award-schools