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.

I think people need to be clear about what they mean by ‘mental health needs’. Actual diagnosable mental health conditions, self harm, suicidal intent? E.g. ‘anxiety’ is not a mental health condition. It’s a normal part of being. So what are people actually meaning? Teen age years in particular are difficult and emotions are labile and a bit of kindness and understanding from schools, awareness, pshe lessons, appropriate school policies, counselling, pastoral staff are needed. I don’t think that has really changed From when I was young. However, the rise in actual mental health conditions needs addressing by specialist mental health staff. Not writing off as ‘lack of resilience’ .

So my school doesn't exist then?

We still don't reach enough students in need, even with all of that available, I wasn't for a minute saying we had it sorted.
It's just people were asking what could be offered aside from counselling.

@JanglyBeads

I guess it depends on how you define an intervention. A daily check in on how someone is feeling is nothing new and doesn’t warrant the title of an intervention. Teachers have always done that and parents seem to be demanding more.

The peer support movement by other students is definitely an avenue worth exploring but again I think there’s an expectation for more.

All the other suggestions you have mentioned are external and so are not really reliant on the schools own budget.

For some anxiety is a mental health condition. There are various anxiety disorders in the ICD-11 and DSM-5.

School has to pay for the interventions eg PT guy?

Isn't anything abover what the average student receives an intervention, so yes daily check in. And that's all some anxious students need.

I forgot, we also try and educate parents about MH, sending out info and inviting them to evening talks in school.

It might exist but it’s unrealistic to expect every school to be like this. It’s school, not rehab.

It’s school, not rehab.

Many therapies e.g. CBT and OT have been deemed educational provision, so while yes additional funding is required it is not unreasonable to expect this to be provided in school.

@JanglyBeads

Well it’s unlikely in a lot of schools they will pay for external providers, particularly with how skint many of them are.

Asking a student how they’re feeling is not a mental health intervention in my opinion. Teachers, particularly form tutors have been doing that for decades. That’s a caring approach yes, but not a specific MH intervention.

An educational approach to MH I’ve already discussed and I think schools do this well (obviously). In spite of this I still see parents on my own kids schools FB page demanding more.

Most students (with a few exceptions) who receive these interventions are in their regular lessons 95% of the time though. Rehab it ain't.

No anxiety is not a mental health condition. Anxiety DISORDERS are

@RibbonRed

Cloud cuckoo land I’m afraid expecting schools to offer OT provision and CBT by trained registered healthcare professionals. If a school is struggling to pay for a qualified teacher you can sure as hell bet they can’t afford a CBT practitioner. That is the remit of the healthcare service.

Asking a student how they’re feeling is not a mental health intervention in my opinion.

Daily check-in at my school is not done by a form tutor and can incorporate a search for sharp objects in case they try to self-harm in school. The check-in could be to establish whether they are ok to go to lessons or need to stay in our support centre.

I don’t doubt that it’s helpful but I think that there are many parents who are definitely expecting more than that to be delivered whilst in school.

I did say "to assist with varying levels of need"!

I did say anxiety disorders are in the ICD and DSM. For many they will use anxiety as a shorthand for saying the anxiety disorder they are diagnosed with.

Not cuckoo land. I know plenty who have such provision in schools, either via EHCPs, pupil premium, ASF or charities. Again, I acknowledged additional funding is often required, but there are avenues to secure that additional funding. Anything that ‘educates or trains’ is an educational need and that includes therapies such as OT, SALT, CBT.

I think there’s quite a lot of evidence that school is the best place to provide interventions including mental health, occupational therapy, salt etc. having to travel to these is incredibly disruptive to children and results in them missing a lot more education, social time, routine. I don’t think this has to be provided by the school but they should be facilitating it and it should be seen as a priority

@JanglyBeads

Yes I appreciate that. It was only last week I seen a post on my own sons schools FB page from multiple parents slating the schools MH provision. From what I can see they’re doing the best they can. They provide an in house qualified counsellor. They have a hub for students with higher needs, and they regularly hold MH online workshops in the evening to educate young people and their parents about MH etc. I am just not sure what more these parents think the school can do.

A full 10% of the students in our year 11 in our large school are not attending due to mental health. As a society we need to be looking at how these kids are getting screwed up so young

@RibbonRed

There are plenty of kids who need help who don’t have EHCPs and are not entitled to FSM. External help is also a bit of a postcode lottery so yes I do think you’re living in cloud cuckoo land. Plenty of schools are desperate for outside agencies to come in but to no avail.

I agree, rather than blaming the kids I think unfortunately we have to admit that we seem to have failed them.

I don’t think this has to be provided by the school but they should be facilitating it and it should be seen as a priority

But it needs to be acknowledged that schools don't even have the staff to perform their basic job of teaching kids, and so expecting extra services to prop up the failing NHS is unreasonable.

It's absolutely dire... we have a dedicated pastoral team including well-being staff and numerous counsellors who come in. They are normally in the last year of their degree so not that experienced. We then have 1 counsellor who is qualified to a higher level. We are supporting young people in absolute crisis who aren't meeting thresholds, who've had numerous attempts on their lives. We aren't trained to deal with the level of help needed. The waiting lists are massive and there is no help while you wait! The effect on the staff is huge cause everyone cares snd worries about kids when we go home.

Even the young people who do meet threshold and need hospital care can't get it as there are no beds. Young people are dying while they wait! The damage done is far worse than it needs to be if good quality professional support is available in a timely manner. It isn't though... it's actually terrifying to be a part of at times.

I don’t think I said all of pupils did, did I? But if a pupil has such significant mental health needs they need the therapies listed above their parents/the school should apply for an EHCNA. No, it’s not immediate, yes it may take an appeal, but if their mental health difficulties are so severe then an EHCP is possible and therapies secured via that route.

I think it’s one of those things that unless you’re in need of that service then you don’t really know. My kid wasn’t bullied, was that the anti-bullying policies etc or was it luck? If there’s a large enough minority complaining the school aren’t tackling bullying I’d presume it’s luck.