Mental health in secondary schools

[Bigfatlie]

I have NC for this.

I am part of the pastoral team of a large secondary school, and I have noticed not just a massive decline in the mental health of young people (and their parents for that matter) but also, from my own perspective, the provision has progressively dwindled. This scares me so much.

I used to love my job and felt that it mattered as I performed a pivotal role in a child's wellbeing, road to recovery, etc. I have done this for almost 9 years with the school having provided zero training for me. Nothing at all. I have made it my business to educate myself, and this has been at my own cost and in my own time. In those 9 years I have dealt with more and more complex cases, including attempted suicides, and I still have not received any training, or support for myself for that matter.

I am not sure how much parents are aware that many of the pastoral members that look after your child's mental health are not trained at all. They're just people like you and me who probably got a lowly paid job at a school in order to work term time only.

What I am hearing now pretty much on a daily bases is parents asking school to provide interventions because their GP has said 'school will put something in place'. I don't know about other schools, but where I work, this means that very complex cases (neurodiversity, suicidal ideation, eating disorders, self harm, potential mental health disorders, etc), get shoved towards a member of the pastoral team who's meant to make a difference to that child's wellbeing, having had zero training, and having to balance the demands placed upon them from other aspects of school that get prioritised over mental health EVERY TIME: attendance, uniform, detentions, and general compliance.

I am not sure how much parents realise that schools are not always honest about the fact that they do not have qualified staff to deal with most emerging mental health difficulties. Quite often we have children joining in Year 7 with a history of mental health difficulties, and parents expect school to deploy a whole host of interventions. Whilst I believe that schools are ideally placed to deal with the mental health difficulties of our young people, this is simply not the reality because there's no funding and no training is allocated to non-teaching staff . The result is that our young people deteriorate, and the adults being paid nearly minimum wage for addressing these difficulties are on constant burnout mode, often developing mental health issues themselves.

The difficulty for parents of course is the fact that when they take their child to the GP, they learn that CAMHS' waiting list is 2 to 3 years, and then get reassured by the GP that 'school will put something in place'. Parents out there, you want to question schools as to what qualifications the person looking after your child's mental health has. What the interventions that schools put in place really mean. Their frequency, consistency, are they evidence based... Don't be fobbed off. Make sure they're not just paying lip service, because from where I am standing, that's all that's on offer right now.

Actually, I am going to post this:

People need to have a good think about taxes, and what happens when keeping taxes low becomes the be all and end all of your voting priorities.

You end up with a shit-hole, where public services are in their knees, and only the people sitting in top of a bloody fortune are having a good time, while everyone else is working flat-out to try and avoid freezing, going hungry, getting I'll, or falling into a place where they need non-existent public services.

Or working flat-out in those scant public services, trying to deliver care to those who need it because they care. They care about the children they need to educate, they care about the patients they need to get well, they care about the sad, angry children who need to be listened to and put back together, they care about the lost adults,the elderly, the disabled ....the list goes on and on ...

And actually, if you are someone who is terrified of voting for a change to this evisceration of public services in case it raises taxes, someone who would rather watch everything burn away to nothing, rather than risk a couple of pence on the higher rate tax band ...

Don't.

Because I guarantee Labour is so scared of losing your vote, they won't dare raise taxes.

This country is so gripped by the fear of raising much-needed money through taxes, you're pretty safe.

But I'm not a politician, so I can just say it.

That attitude needs to change.

Because - right now - the most vulnerable are paying.

And they are paying with shortened life expectancy and quality of life.

And that is profoundly morally wrong.

And our young people are paying.

And that is not fair.

If you have children, you owe them your care - and chat should mean paying taxes to pay for the services they require now and in the future.

And society needs children - and society as a whole should pay taxes to provide the services that children - as a whole - need and deserve.

We've had years of propaganda, telling us to be selfish. To pay less tax. To defund public services and just buy our own, individual, way out of need for them.

And, strangely enough, children are paying a high price for that.

The attitude needs to change. People need to understand that being an adult is about being responsible. And part of being responsible is about widening 'responsibility' to include a sense of acting responsibly towards others.
Pure selfishness (dressed up as individual responsibility) is not full, adult responsibility.

The core business of a school is education.
More and more we're being asked, forced or expected to pick up other roles because other services are broken.
It's not our job and it shouldn't be happening.
We shouldn't be patting ourselves on the back for doing it.
We should be refusing and pushing back, not because we don't care but because we do.
Schools are not and should not be the place where all problems come to rest.

I'm re-posting this because it's such an important point.

I’ve worked in pastoral roles in secondary and I can assure you NONE of the “interventions” are evidence based as the staff are NOT trained. A 1200 pounds two day training course does not mean you are “trained”. The only people who are “trained” to deliver MH interventions are:

• qualified counsellors. Qualified being the key word as it’s not a protected title
• educational MH practitioners who are employed via the NHS
• MH nurses and MH social workers/OTs

A lot of the MH “interventions” in school are quite simply dangerous practice but staff do their best I guess. Also pastoral staff receive ZERO supervision in regards to their own MH and are expected to wear every single hat under the sun.

This doesn’t mean that what they do isn’t very helpful (it is and I’ve made a difference over the course of my career), but I wholeheartedly agree with the OP.

More and more we're being asked, forced or expected to pick up other roles because other services are broken.

It's not our job and it shouldn't be happening.

That is true. Schools should not be using funding that should be paying for e.g. maths teachers to prop up the lack of NHS mental health services for children. But that's what's clearly happening.

Schools should not be using funding that should be paying for e.g. maths teachers to prop up the lack of NHS mental health services for children. But that's what's clearly happening.

And every time we reduce the burden on the system by picking up the slack, we enable some bean counter somewhere to say "actually we don't need any more whatevers because demand on the service has reduced".

And so the cycle goes on with schools becoming everything to everyone.

It's the same with schools dipping into their funding (or their own pockets) to pay for free breakfasts for hungry kids or whatever, so the government can say that they don't need to raise the threshold for free school meals.

It's the same way that food banks let the government off the hook.

As CatfromJapan was talking about above, posters moaning about an increase in taxes - do you think that a good education provision or a stable NHS are not worth paying a bit of extra tax for?

And if you're thinking 'well I send my kids to an indie school and pay for private medical insurance' - you're being forced to pay for these things privately at an increased premium than you would have to pay for in tax to get a decent service from the state.

Absolutely this.

I have done anA-level and MSc in Psychology. I have volunteered extensively as a peer supporter and obtained counselling experience through that. Professionally, I work in a completely different field but I am probably more knowledgeable about early years and child and adolescent mental health than many. I have also had 2 rounds of CBT with an NHS practitioner due to my own anxiety, which has helped enormously so I am familiar with some CBT processes.

My youngest had anxiety issues in year 3 and I managed to work with her through that with the help of some excellent books. I was lucky enough to know techniques that help with anxious thoughts and also that she was receptive and responded well to these.

Due to some difficult social dynamics in her class, the school suggested my dc has weekly sessions with the mental health support worker for about 6 weeks. She went twice and I pulled her out of it. All they did was watch Youtube videos on how to deal with anxious thoughts and my dc got lots of lovely one-on-one time with this mental health support worker. Of course she loved it and felt special to be treated so warmly and nicely (more fun than sitting through challenging maths with difficult classmates). As soon as she started the sessions, dd began seeing herself as someone who struggles and is anxious and needs to lots of support (at the age of 8!!). That's the opposite of what I wanted for her, I want her to learn to cope and be resilient. These mental health and wellbeing support workers mean well but simply haven't had the training and experience to deal with very vulnerable children. In some schools this provision has become a tick box exercise, not great. The worst thing about our 'counsellor' was that she gave dd a session BEFORE I had actually consented to it, which is so unprofessional and instantly undermined my trust in her abilities. Any person who speaks to my dc about their inner most feelings and fears would first be hugely scrutinised by me. They can and do more harm than good when it goes wrong. Where possible I'd go wire reputable clinical psychologists. When I was doing peer support it was drilled into us that we must never advise, that's for the professionals.

And every time we reduce the burden on the system by picking up the slack, we enable some bean counter somewhere to say "actually we don't need any more whatevers because demand on the service has reduced".

Yes. Like whoever the idiot was who said ‘headteachers are very clever people’ when challenged about school funding and the issue of suggesting a teacher’s pay rise but not giving schools any money to pay for it. Knowing full well that schools, like ground down victims of abuse, would just go ‘well yes, of course it’s our problem to sort out, we can’t possibly stand up to say it’s the government’s fault’.

Teachers’ pay rise. Sorry.

I think that, generally speaking, there's an expectation that mental health professionals (and I mean the trained and qualified ones, not the ones who've tagged on a two day course) can put in interventions and resolve mental health crises easily. We cannot. Often, but not always, the problems are rooted in family trauma and exacerbated by social issues such as financial difficulties.
I think the expectations are way too high.
We can offer free really good, therapeutic support and coping tools, but the biggest problem is fundamentally the way society is structured and the education system itself, which is not working for a massive number of students. Huge change is needed. We can support and put measure into
place, speak to teachers and write
reports to request reasonable adjustments, but the way society works and the way schools work also needs to change.

not free! Don't know where that typo came from
. I get paid!

we had a qualified counsellor and a full time school nurse. Then came the tories. Budgets were cut. You cannot run a school without teachers so guess who we could no longer afford?

problems are rooted in family trauma
this. The is beyond anything a school can deal with as everyone else in that home will continuously be contributing to that trauma. It needs a much bigger approach.

@novemberlights

Yep totally agree. Parents want their children “fixing” without taking into account family dynamics that actually worsen their own child’s MH, thus passing the blame on to someone else (usually the school). It was just this past week I read a parent ranting on my child’s schools FB page about how awful the school was at helping with mental health and they should know better because THEY know how much she (the mum) suffers with her own MH.

Dear god it’s an educational establishment not an inpatient facility. Perhaps if the mum took more proactive steps to nurture her own MH then her child might actually have better outcomes but hey, the concept of personal responsibility seems to have passed a lot of people by.

I guess it comes down to a large section of society who fell for the mental illness is just like a broken leg rhetoric.

I’m a senior mental health lead and I’ve completed the £1200 course mentioned above. It’s a course about how to word your policies and use outside agencies. (CAMHS, hollow laugh), not how to provide mental health care yourself.

I’ve had GPS tell parents of kids just out from a suicide attempt that ‘the school will support’. I have a degree in a humanities subject.

id laugh if I didn’t regularly sob.

I'm the mental health lead in a large primary school. Our caseload doubled last year, and is still continuing to grow.
We are increasingly getting GPs telling parents to access support through school, due to long waits in CAMHS. We also have CAMHS doing initial assessments (after a long wait), identifying that children need support but asking us to take it on as there wait list for the support needed is over 6 months. These are often very complex cases.
We are also seeing much more mental health needs in our parent community. We are seeing a big increase in anxious parents making increasing demands on teachers workloads.
We prioritise mental health in our school and have a school counsellor. However, we do not have the resources to help all those who are asking for support.
I'm fed up of hearing that the government are prioritising schools and mental health, because it is only words, whilst they leave familiar and schools to sink.

We should not be having to prioritise mental health.

And it’s worth mentioning that “school counsellors” whilst qualified are usually only qualified at level 4. That’s not a criticism but it’s highly unlikely that a level 7 qualified counsellor would work for the money that schools offer. (I know I’ve looked at a lot of the job specs).

For context CAHMS wouldn’t touch a level 4 qualified counsellor. The NHS only employs counsellors who have completed a masters PLUS a two year post masters accreditation.

I agree that there is a tsunami of mental health problems in young people. Referrals in to CAMHS and partner mental health services (CAMHS being just one provision for young people's mental health in most areas) have shot up, and I can appreciate the burden on schools is massive.
There has been a lot of investment into brand new Mental Health in Schools teams in many areas of the country though OP, does your area not have that? Or maybe your school has not signed up for that service? - I would make some enquiries at your school.
I do not recognise when you say "CAMHS' waiting list is 2 to 3 years". It has never been that long in any of the CAMHS services I have worked in. I appreciate some CAMHS services struggle with long waiting lists but I have never come across it longer than six months for 'routine' mental health care. In my service we see urgent cases within seven days, and 'routine' cases are allocated to a therapist in around ten or twelve weeks. If they need same day assessment due to suicide risk, they can get it, via A&E.

having sat in on sessions with both level 4 and level 7 trained therapists with my autistic daughter and having professional experience of working in this field, the difference is surprisingly small! Except perhaps that a psychologist or Masters educated therapist might be more medical model trained, so looking more towards a "what's wrong with you" rather than "what happened to you" explanation. I'm always quite surprised when posters on mn will advise someone to
pay £150 an hour for a clinical psychologist promising them that they'll get a better outcome than "just a counsellor." All research (which often is only carried out on measurable therapies like CBT) points to the fact that the therapeutic relationship is the best indicator of success and not the modality.

One hundred percent agree

@CAMHStherapist My DD was referred to CAMHS May 2020. In Dec 2021 we were still waiting, we eventually said she could come off their waiting list at some point this year when she had an EHCP in place and she had improved sufficiently due to private intervention.

I do not recognise when you say "CAMHS' waiting list is 2 to 3 years".

I suspect it may be ‘smoke and mirrors’ to do with what counts as ‘the waiting list’. I count the time from someone stating ‘CAMHS involvement is needed’ to being seen - via, of course, inability to get through; ‘We’re very busy so don’t bother us for a while’; threshold has risen so no longer meets the threshold of need to be seen; need to see another rare professional to be properly referred and get lengthy forms filled in; ’try this intervention at school for x weeks and see if it works’ x 2 or 3; it’s the holiday now, let’s see how it is next year; then endless brush offs until finally getting seen after many months. From CAMHS point of view, very little of this may count as ‘the waiting list’. From the young person’s point if view, it is 2-3 years from initial identification of the need.

We need to dig a little deeper. Why are kids so unhappy compared to 15–20 years ago?? What’s going on?!

I genuinely don’t think there’s enough qualified practitioners to adequately treat all the mental health problems out there even if the funding happened.