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 don't do solution focus therapy with my students I work with now, sorry should have made that clear. But I do have training and experience was what I was saying but I'm aware very few school staff do. Even then I feel we should just be able to refer to services straight away and get help. School staff should not be providing mental health programmes or work.

We provide so much support to students every single day.

More often than not we deal with the fallout from a shitty CAMHS meeting.

@Anonforthis122 An EHCNA is the initial needs assessment you request before the LA decide whether to issue an EHCP or not.

Email the LA’s Director of Children’s Services informing them of the situation and reminding them of their duties under s.19 of the Education Act 1996. If that doesn’t work email again requesting provision otherwise you will be forced to begin legal proceedings. If that still doesn’t work contact SOSSEN for help with a judicial review pre-action letter.

In addition to this, apply for an EHCNA. IPSEA have a model letter you can use. IPSEA and SOSSEN have helpful information on their websites and have advice lines.

If you start a thread on the SEN or SN boards posters will support you through the process.

@BungleandGeorge

I disagree. It can still be very useful for tier 4. Usually extensive psychotherapy over a longer period of time is needed by that point. Also in tier 4 you can get access to counselling psychologists which are usually pie in the sky at lower tiers.

One of the huge benefits of being an inpatient in tier 4 is obviously safety and meds, but also access to intensive psychotherapy sessions which can often be daily for the most severe of needs. Counsellors absolutely do have to use evidence based interventions, I think you are potentially talking about unqualified practitioners.

Thank you . I have screen shot your message so I can look all of that up.

Hopefully I can get some reports /evidence from CAMHS to help with that as well

@Anonforthis122 You have enough evidence to get over the initial threshold for an EHCNA. Then the needs assessment can provide further assessments specifically for the EHCP process from e.g. OT, SALT, psychiatrist, clinical psychologist.

If LA refuse to assess or issue do appeal, the majority of appeals are upheld.

How do I have enough evidence? Also ds refuses to engage in alot of stuff. So I don't understand how they do the assessment etc .

My younger son has an ehcp . But it was basically done for me by his school. So I have no idea what I'm doing.

Also when I write things down I just sound like I'm moaning about a hormonal teenager .i don't know how to put it across so its taken more seriously.

@Anonforthis122 The initial threshold for an EHCNA is relatively low - a) has or may have SEN, and b) may need SEN provision to be made via an EHCP. You will be able to prove that since DS is unable to attend school or college at all and has significant mental health difficulties via information that already exists from CAMHS, school and college. Although, obviously, more evidence wouldn’t hurt.

A good professional will be able to assess even if DS struggles to engage.

IPSEA’s model letters are a good starting point.

Another thing I've noticed about pastoral staff in schools is that it's very common to have a poor understanding of confidentiality/GDPR.

I've had staff pull me over in corridors to try and talk to me loudly about extremely private and personal information pertaining to the student and their family.

I've even had staff tell me very personal details about a student I'm not even seeing, they've just assumed because I'm from X organisation I might be the practitioner the student saw and without checking have launched into telling me very personal details about a student.

The very basics seems to be lacking.

This is interesting because I often get told off by other staff for not sharing information with them about a student. Staff seem to think they should be allowed to know everything. I always think about what the teenager would want people to know. Most of the time I ask them if they want their form tutor to know, or if they would prefer to let someone else know. Unless it's safeguarding, I feel students should be allowed to decide themselves who knows stuff about them.

I don't have evidence from school they just think he was playing up and bunking. I don't have any reports from camhs yet.

Thank you to everyone that has replied. I have found this thread very cathartic, as I have no one to offload to.

The resilience argument is an interesting one. There's a million valid reasons why some students (and their families) don't have the capacity to to tap into their 'resilience pool'.

Having said that, there are many cases where parents at home (and I am a parent of 1 primary aged DD and two teen DSs myself) are not doing the very basics because they can't, or don't want to, deal with the daily grind that is developing your own children's resilience. It is exhausting work that goes on for years and years and often seems to go nowhere, yield no benefits, or the minute you feel you're getting somewhere, you find you're back to square one. All while trying to meet the needs of different aged children in different stages of development, hold on to your own job, possibly marriage problems, ageing parents, your own mental health, etc etc.

All of that is a part of parenting, and there's a massive drive to outsource this side of parenting off to schools because it is ugly, uncomfortable, exhausting, draining, and thankless.

I often find that parents complain to school because their kid is feeling anxious, and when you have a conversation with the child, you find that their very basic needs have not been met at home. Some children arrive in school exhausted, having had very little sleep because they're on their screens. They've eaten no breakfast, or a high sugar breakfast. They have no water bottle and drink nothing all day. They have chocolate bars and crisps for lunch. It's pouring down outside but they have no coat. They have no routine, no expectations to exercise, no space and time to offload....

Sometimes these parents are the most vocal, because they know they're failing so miserably, but instead of doing something about it, they project the blame on to someone else and hope for a miracle so that their kid stops being a 'pain' at home.

I just want to say in terms of the year manager/pastoral check-ins. Very little can be achieved in a 10 minute conversation. Children need the right environment to be able to open up. The development of a trusting relationship takes time. These conversations need to happen in the right setting, i.e. a quiet room, with a member of stuff who's not feeling harassed by the trillion things they need to do, and can give the student the time and space to address issues. This is like gold dust.

The previous pp who said they didn't feel supported by school when going in to do interventions. Going by what it's like in the school where I work, I am guessing this is not because they don't value your input, but more because it takes a dedicated person to facilitate a meeting like this, which requires several people informed, a meeting room booked (ha ha ha), the student informed (might be a student who only attends school sporadically), dbs checks, and other things that may seem minor, but actually can take a hell of a lot of someone's time who already has a million things to get to by morning break!

As for the Mental Health Lead training. I appreciate the government has given £1,200 to schools to get someone trained on delivering mental health interventions. But this implies that schools have a dedicated member of the leadership team whose focus is wellbeing/mental health, and not attendance, safeguarding and behaviour. I don't know enough about this scheme, but again, it is offering training on delivering policies, but what we're lacking here is training and support for the people on the frontline, actually delivering those interventions to extremely vulnerable young people.

I've read the thread and people asking what schools can do.
In my DD's case there were things that would have helped prevent/delay:

• the SEN department should have told us her screening scores rather than just use words like 'below average'. It was only much later that I came to understand that term had a specific meaning much worse than I had realised
• She should never have been given a full GCSE timetable in y10, it was just far too much for her (see point above)
• not to have every teacher regularly talking about how important GCSEs are and to work hard. (we told her they weren't aiming at her, she was trying, but it didn't help)

As it was her collapse coincided with the start of the pandemic, and there were serious other factors at play too, but those 2 points above definitely didn't help.

I also think talking about mental health is an awkward one as you have to be careful not to put ideas into teen's heads. So any talk about anxiety needs every time to be couched in terms of 'feeling anxious is normal, especially around exams, these are things to keep you calm', as well as 'in a few cases ....'

I suspect there is a significant minority of pupils for whom the new GCSEs are just too hard. And then at the upper ability, the existence of 9s puts stupid unnecessary pressure to achieve the top grades and the feeling of failure if they 'only' get 8s.

For my DD (with a diagnosed anxiety disorder) the support she now gets in college is great. A quiet area between lessons, and a red card pass to remove herself from lessons if necessary. But her college is much larger campus, and much smaller classes, and she is doing a pre-GCSE level course. I don't think it would have worked in a school setting.

@Anonforthis122 There will be evidence from college, school and CAMHS that already exists even if you don’t physically have it e.g. DS’s attendance record, notes from CAMHS assessments, emails. You might need to submit SAR requests to get copies of it.

All good points OP, although IME if the quick daily check ins come off the back of an initial proper private meeting with child (and parents probably) where all issues are raised, it can be helpful.

We also provide Time Out cards where appropriate.

Our MH Lead is Head of Psychology (the academic dept), not SLT but she carries weight iyswim.

A very interesting thread.
I completely agree that school staff are expected to support students with mental health and I don’t think it’s appropriate for this to be placed on schools without appropriate staff in place.
My own experience - I am in an admin role but often have to help students who are having a panic attack, or are crying and overwhelmed, or say they need someone to talk to. I have no training but when there’s a young person in front of you in distress you can’t just say ‘that’s not my job to deal with you’.
We are very fortunate and do have access to a school counsellor so once the student is calmer I will suggest they can contact the counsellor if they wish and direct them to other local sources of MH support. I am very careful not to offer any advice myself as I don’t want to say the wrong thing.
I really wish we had someone I could call on for these situations, like a first aider. (And of course whilst I’ve sat with a student for half an hour / 1 hour until they are calm enough, my own work has piled up). Often they are already getting counselling but still have panic attacks anyway.

We also have many students with anxiety / depression / self harming.
Parents often contact the school for help first. It starts with the parent saying their child is struggling and asks for a member of staff to talk to the child. So the teacher has a chat to the child and when it becomes clear the issues are mental health, they will offer the school counsellor but also recommend the parent goes to the GP. The parent then often complains the school is not supportive enough. I think some parents are hoping the school can ‘fix’ their child and get upset when we can’t.

There’s no support for teachers either, it can be quite upsetting and draining trying to help students and families with MH issues, and many school staff have their own life issues to deal with but there’s little recognition of the burden this places on them.

TeenDivided
Talking about GCSE scores is the teachers job. The school is there to teach those GCSEs and ensure teens pass them.

Talking about mental health and including anxiety in these discussions again is what teachers are told to do. Teens also see their peers telling their teachers and parents that they have anxiety. They see these friends might be on part time timetables or might spend their time in pastoral support. They may think they feel the same and may say they need the same support. What do teachers do then?

Having different qualifications for students with send might be a good idea but this does not fit with the current push to make our qualifications more rigorous. Nor does it fit in with the inclusion agenda. Many schools now have even dropped setting meaning that students who need reduced content or a slower pace find things even more difficult.

@Bigfatlie

Sat here nodding away at your last post. Totally agree.

There’s no support for teachers either, it can be quite upsetting and draining trying to help students and families with MH issues, and many school staff have their own life issues to deal with but there’s little recognition of the burden this places on them.

Twice in a very short space of time I had students disclose to me. I followed all the processes I had to follow. When I then went to speak to the DSL, because I was struggling with what I had heard, I was brushed off. In my experience, that's normal.

In our area the CAMHS waiting lists are very long, 1-2 years. Parents who can afford to will go private. In reality this means a visit to an educational psychologist who’ll write a long list of things the school should be putting in place for the child, without any idea of whether this is possible, or practical. The parent will send school the letter and expect it to all to magically appear because a professional has recommended it.

For example, one recommendation is often for the school to provide on-line lessons when a child is too anxious to come to school. It seems to be an outcome of Covid that because lessons were provided online during lockdown, theres an expectation that the school can do it anytime. Who is supposed to provide these online lessons? The teacher is in the classroom delivering a lesson, they can’t teach online at the same time. We don’t have teachers sitting about doing nothing who can deliver online lessons. The most the teachers can do is send home work to complete, but again this all adds to their workload. And you can guarantee that a child who is off with anxiety is not going to sit at home and work through a load of PowerPoints.

I don’t know the solutions. I just know that schools cannot meet the needs of the many children with MH issues but we aren’t allowed to say this.

@cansu

Yes there’s definitely some teens who will think they need the same support as their friend in pastoral when they’re just feeling a normal level of anxiety over their exams etc.

Off topic slightly but last year my middle child who was in year 4 at the time started to say she had anxiety. I was confused at this as she seemed perfectly happy to me. The teacher got to the bottom of it, turned out she wanted some toast during maths like one of her friends (who gets taken out of the lesson during times of anxiety for toast) 🤦‍♀️.

What annoys me is the week DD was referred to CAMHS two adults I know were suffering the same issues - both went to the doctors, both were given antidepressants and both put forward for counseling -

Neither waited 1-2 years for a first appointment , yet this is acceptable for children?

Their is a difference though, within an organisation information on a student should be shared if it is impacting their studies with the teachers - it is as if asking a teacher to teach a class with one hand tied behind their back

one recommendation is often for the school to provide on-line lessons when a child is too anxious to come to school.

Online provision is a perfectly valid recommendation, but it isn’t the school’s duty to provide it, it is the LA who have a statutory duty to provide education to those unable to attend school full time. Online provision via medical needs tuition was around long before Covid. Work sent home from schools is not enough to relieve the LA of their duties. Schools should support parents in securing the provision from the LA.

If the school can’t reasonably put in place the recommendations included in professional reports they should suggest the parents apply for an EHCNA.

But isn't it better to have level 4 (of which I am one myself) than nothing at all or school member trained by a single course?

Also level 7 can be problematic depending on what route they took. I know one who have done fewer client hours than I have as it was not a requisite for their course. Yet people not in the know will just see he is level 7 qualified.

Yet another reason to look into some stricter rules over what a counsellor is/ who can call themselves a counsellor.

I am working towards my level 7 but it will take some years as I've changed modality and am now specialising in Transactional Analysis.
Only 1 other of my level 4 trainees have continued to further training.

I agree training is the key but by level 4 100 client hours is expected ( if Bapc compliant) and someone has to be that no 1 client For level 4 and level 7.

I haven't made it all the way through this thread yet but your comments here intrigued me.