Promoting children and young people's mental health and wellbeing
Promoting children and young people’s mental health and wellbeing A whole school or college approach
Public Health England working with the Department for Education
Promoting children and young people’s mental health and wellbeing
Contents
Rationale ..................................................................................................................................... 5
Chapter 1: Leadership and management .................................................................................. 11
Chapter 2: Ethos and environment ........................................................................................... 14
Chapter 3: Curriculum, teaching and learning ........................................................................... 16
Chapter 4: Student voice ........................................................................................................... 19
Chapter 5: Staff development, health and wellbeing ................................................................. 21
Chapter 6: Identifying need and monitoring impact ................................................................... 23
Chapter 7: Working with parents, families and carers ............................................................... 25
Chapter 8: Targeted support and appropriate referrals ............................................................. 26
Resources ................................................................................................................................. 29
Appendix ................................................................................................................................... 38
References ................................................................................................................................ 41
Promoting children and young people’s mental health and wellbeing
Introduction It is widely recognised that a child’s emotional health and wellbeing influences their cognitive development and learning (1,2) as well as their physical and social health and their mental wellbeing in adulthood (3,4,5).
This document describes 8 principles of a whole school or college approach to promoting mental health and wellbeing which, if applied consistently and comprehensively, will help contribute towards protecting and promoting children and young people’s mental health and wellbeing. Each principle is considered together with some examples from practice and a question to help the reader to reflect on the implications for practice in their own setting. The document also signposts to resources to support implementation of a whole school or college approach (covering government guidance and advice, training for education staff, curriculum support, resources for young people, parents and carers) and examples of a range of organisations that provide mental health and wellbeing support focussed on school and college settings. This document will be useful to anyone responsible for promoting and supporting the mental health and wellbeing of children and young people in schools and colleges, including headteachers, principals and their senior leadership teams, school and college governing bodies, senior mental health leads, SEN and pastoral leads, school nurses, educational psychologists and local public health teams.
Other recommended reading includes the statutory guidance on ‘Keeping children safe in education’ (13), ‘Supporting pupils at school with medical conditions,’ (6) ‘Relationships Education, Relationships and Sex Education (Rse) and Health Education (7), ‘Promoting the health and wellbeing of looked after children’ (8), as well as advice for school staff on ‘Mental health and behaviour in schools’ (9), and on ‘Counselling in schools’ (10).
The government’s Transforming Children and Young People’s Mental Health Provision: a Green Paper also sets out ambitious, transformational proposals for health and education systems to support and promote mental health and wellbeing for children and young people (14). The proposals place schools and colleges at the centre of plans to embed a culture of openness around mental health and forge stronger links between education and health to ensure children and young people can access appropriate support. The key government commitments from the Green Paper include: 1. To incentivise and support all schools and colleges to identify and train a senior mental health lead with a new offer of training to help leads and staff to deliver whole school or college approaches to promoting better mental health (28). 2. To fund new Mental Health Support Teams, including supervision by NHS children and young people’s mental health staff, to provide specific extra capacity for early intervention and ongoing help. 3. Trial a 4-week waiting time for access to specialist NHS children and young people’s mental health services. This builds on the expansion of specialist NHS services already underway.
Promoting children and young people’s mental health and wellbeing
Other relevant government guidance can be found in the resources section at the end of the document alongside other useful documents such as guidance from the Pshe Association on teaching about mental health and information on Mental Health and Wellbeing for the Further Education sector available from the Association of Colleges.
Promoting children and young people’s mental health and wellbeing
Rationale
Good mental health is important for helping children and young people to develop and thrive. The Mental Health of Children and Young People in England survey (2020) found 16% (1 in 6) of children aged 5 to 16 years to have a probable mental health disorder, an increase from 1 in 9 in 2017 (11). The coronavirus pandemic has resulted in fundamental changes to the lives of children and young people. The Public Health England COVID-19 mental health and wellbeing surveillance report suggests that whilst some evidence shows that children and young people have generally coped well during the pandemic (March to September 2020), other evidence suggests that some children and young people, especially those with certain characteristics, such as those who are disadvantaged economically, females, and those with pre-existing mental health needs, appear to have experienced greater negative impacts on their mental health and wellbeing (12).
Schools and colleges have an important role to play in supporting the mental health and wellbeing of their pupils and students, by developing approaches tailored to the particular needs of their pupils and students. Taking a coordinated and evidence-informed approach to mental health and wellbeing in schools and colleges can also help foster readiness to learn.
Ofsted’s School inspection handbook sets out what inspectors take account of, as part of school inspections, to ensure schools are providing good education, supported by high- quality pastoral care, to enable their pupils and students to develop into resilient adults with good mental health. This includes making sure that pupils and students know how to keep physically and mentally healthy (29).
All schools are under a statutory duty to promote the welfare of their pupils and students, which includes preventing impairment of children’s health or development and taking action to enable all children to have the best outcomes. Full details are set out in Keeping Children Safe in Education (Kcsie) statutory guidance (13).
Promoting children and young people’s mental health and wellbeing
Figure 1. Life experiencesabcdef in a class of 30 pupils (Image provided by the Centre for Mental Health).
References are from the following sources and mainly relate to secondary school-age children. a Fauth, B., Thompson, M. & Penny, A. (2009) Associations Between Childhood Bereavement and Children’s Background, Experiences and Outcomes: Secondary analysis of the 2004 Mental Health of Children and Young People in Great Britain data. (viewed on 19 September 2021) b Office for National Statistics 2021 Families and households in the UK: 2020 (viewed 19 September 2021) c NHS Digital (2020) Mental Health of Children and Young People in England, 2020: Wave 1 follow up to the 2017 survey (viewed on 19 September 2021) d Department for Work and Pensions, 2021 Households Below Average Income, Statistics on the number and percentage of people living in low income households for financial years 1994/95 to 2019/20, Table 4_2tr (viewed 19 September 2021) e Brooks, F., Klemera, E., Chester, K., Magnusson, J. and Spencer, N. (2020) Hbsc England National Report: Finding from the 2018 Hbsc study for England. Hatfield, England: University of Hertfordshire (viewed 19 September 2021) f Brooks, F., Klemera, E., Chester, K., Magnusson, J. and Spencer, N. (2020) Hbsc England National Report: Finding from the 2018 Hbsc study for England. Hatfield, England: University of Hertfordshire (viewed 19 September 2021)
Promoting children and young people’s mental health and wellbeing
Figure 1. Text alternative Figure 1 demonstrates some of the life experiences that young people in education settings face. It shows 6 rows of 30 pupils. The first row highlights 1 pupil in green (the remainder are shaded grey) signifying that 1 pupil out of a class of 30 could have experienced the death of a parent or sibling. The second row highlights 4 pupils in green to indicate that 4 could be living in lone parent families. The third row highlights 5 pupils in green to indicate that 5 could have a mental health difficulty. The fourth row highlights 5 pupils in green to indicate the number who could be living in absolute poverty. The fifth row highlights 7 pupils in green representing the number who may have ever self harmed. The sixth and final row highlights 11 pupils in green to show that this number could have experienced bullying. It should be noted that some young people may face one or more of these problems. Early intervention to identify issues and provide effective support is crucial. The school’s role in supporting and promoting mental health and wellbeing can be summarised as:
1. Prevention: creating a safe and calm environment where mental health problems are less likely, improving the mental health and wellbeing of the whole school population, and equipping pupils and students to be resilient so that they can manage the normal stress of life effectively. This will include teaching pupils and students about mental wellbeing through the curriculum and reinforcing this teaching through school activities and ethos. 2. Identification: recognising emerging issues as early and accurately as possible. 3. Early support: helping pupils and students to access evidence informed early support and interventions. 4. Access to specialist support: working effectively with external agencies to provide swift access or referrals to specialist support and treatment.
There is good evidence to support the association between good mental health and education engagement and academic achievement. The benefits to preventing mental health problems in children and young people from arising, and intervening early where they do, can be significant for schools. For example, it may result in improved attainment, attendance, reductions in behavioural problems, as well as happier, more confident and resilient children and young people (9).
The National Institute for Health and Care Excellence (Nice) advises that primary schools and secondary schools should be supported to adopt a comprehensive, ‘whole school’ approach to promoting the social and emotional wellbeing of children and young people (4,5). Such an approach moves beyond learning and teaching to pervade all aspects of the life of a school or college and has been found to be effective in bringing about and sustaining health benefits.
Department of Education (DfE) also identifies a whole school and college approach to promoting good mental health as a protective factor for children and young people’s mental health (14). Although schools and colleges play a significant and valuable role in helping to
Promoting children and young people’s mental health and wellbeing
promote pupil mental health and wellbeing, their contribution should be considered as one element of a wider multi-agency approachg. A multi-agency approach is likely to span children’s social care, NHS children and young people’s mental health services, local authority, education and voluntary and community sector organisations. Eight principles
Figure 2 summarises the 8 principles of a whole school or college approach to mental healthand wellbeing. These are informed by evidenceh (4,5,15,16), and practitioner feedbacki about what works and builds on what many schools and colleges are already doing across the country.
g The Healthy Child Programme, is still the national evidence informed universal programme for children aged 0 to 19. The programme provides the bedrock for health improvement, public health and supporting families. There is national commitment to modernise the programme, to ensure it is current in terms of evidence and context. As part of the modernisation, Phe has committed to extending the programme to include preconceptual care and to extend from 19 to 24 years of age – for those children with a statutory requirement. This includes some of the most vulnerable children, for example those in the care system and with additional health needs or a disability. The revised model, commissioning guidance and high impact areas have been updated with new evidence and emerging policy developments, based on feedback from service users, professionals working in this space and commissioners. h At the time of updating this publication National Institute for Health and Clinical Excellence (Nice) are developing a new guideline on ‘Social, emotional and mental health and wellbeing in primary and secondary education’ which is due to be published in July 2022. This will update Nice Ph guideline 20 and 12. i In 2014 the Children and Young People’s Mental Health Coalition consulted with a sample of teachers, public health and other relevant professionals to test their understanding and application to practice of the term ‘whole school approach.’ The principles as advocated by ‘Healthy Schools’ or ‘health promoting schools’ approaches were considered to be relevant and consistent with effective whole school educational practice.
Promoting children and young people’s mental health and wellbeing
Figure 2. Eight principles to promoting a whole school or college approach to mental health and wellbeing. Figure 2. Text alternative The 8 principles to promoting a whole school and college approach to mental health and wellbeing is presented in a wheel diagram with ‘leadership and management that support and champions efforts to promote emotional health and wellbeing’ at the centre. Radially surrounding this core principle are the 7 other principles below, arranged in a clockwise manner: • Curriculum teaching and learning to promote resilience and support social and emotional learning • Enabling student voice to influence decisions • Staff development to support their own wellbeing and that of students • Identifying need and monitoring impact of interventions • Working with parents and carers • Targeted support and appropriate referral • An ethos and environment that promotes respect and values diversity
Leadership and management that supports and champions
efforts to promote emotional health and
wellbeing
An ethos and environment that promotes respect and
values diversity
Curriculum teaching and learning to promote
resilience and support social and emotional learning
Enabling student voice to
influence decisions
Staff development to
support their own wellbeing
and that of students Identifying need
and monitoring
impact of interventions
Working with Parents and carers
Targeted support and
appropriate
referral
Promoting children and young people’s mental health and wellbeing
The following chapters focus in more detail on each principle and how these relate to school or college based practice.
Promoting children and young people’s mental health and wellbeing
Chapter 1: Leadership and management
To implement an effective whole school or college approach, incorporating the 8 principles requires coordinated change within a setting, and a collective and individual responsibility to promoting and supporting mental health and wellbeing that involves all staff. A senior leadership team that champions efforts to promote mental health and wellbeing is essential to ensure changes are accepted and embedded (4, 5, 9). Having a governor with knowledge and understanding of mental health and wellbeing issues is also highly desirable in championing organisation wide practices. Schools and colleges are encouraged to identify a senior mental health lead as being the strategic lead for implementing the whole school or college approach to mental health and wellbeing within the settingj. Leaders have an important executive role in advocating for the needs of children and young people within the context of wider local strategic planning and in influencing local commissioning arrangements. Transforming Children and Young People’s Mental Health identifies Senior Mental Health Leads as being the strategic lead for the whole school or college approach to mental health and wellbeing within the setting. Whoever leads in a setting needs to understand and be able to explain how a whole school or college approach will benefit everyone, not just to mental health and wellbeing but more broadly improved attainment, attendance, reductions in behavioural problems, as well as happier, more confident and resilient children and young people.
To ensure actions are integrated, sustained and monitored for impact it is important that a commitment to addressing mental health and wellbeing is referenced within improvement plans, policies (such as safeguarding, confidentiality, Relationships and Sex Education and Health Education, behaviour and rewards) and that these plans and policies are reflected through practice (4). It is also important to involve pupils and students, staff and parents and carers in developing these policies so that they remain ‘live’ documents that are reviewed and responsive to the evolving needs of the school or college community. In addition to support from senior leaders, feedback from practitioners highlights the importance of having a champion who will promote mental health and wellbeing across the organisation. Such champions do not have to be senior leaders, but they do need the support of the senior leadership team and governors in order to take work forward in a way that is embedded across the setting.
j Transforming Children and Young People’s Mental Health refers to Senior Mental Health Leads (see Appendix).
Promoting children and young people’s mental health and wellbeing
Key question: How is the school or college providing visible senior leadership for mental health and wellbeing?
Practice examples
At Samuel Rhodes Primary School the head teacher is a champion for promoting emotional health and wellbeing and is an integral part of a multidisciplinary team who support children, parents and staff. This arrangement helps to ensure a good fit between the work of the multi- disciplinary team and the leadership priorities for the school. Hitchin Girls School is developing a whole school approach to emotional wellbeing which it calls Re:mindme. Its psychology teacher champions the work but has established a working group with representation from staff and students to steer the work forward. Support from the head and senior staff is helping to ensure effective implementation. An integral part of the approach has involved staff being encouraged to think about their own emotional health and wellbeing and how they can be role models for the students. The Harbour School is a special school in Portsmouth that has established a whole school approach through strategic and systemic planning reflected in their school development plan. There are 5 key strands in this plan which are systematically and robustly reviewed: • attendance • social and emotional progress • behaviour, exclusions and reintegration • curriculum achievement and attainment • outreach services based on one of their school sites
A whole school approach is vital at Ashfield School when meeting the mental wellbeing needs of pupils. Becoming a Mental Health Support Lead within a large school was made possible by careful planning and having a strategy that allowed a whole school approach. The Pastoral Teams in each year group and support from the Senior Leadership Team has enabled the school to implement a plan to raise awareness of mental health and wellbeing through assemblies, organising a ‘Dress up at Home’ day when in lockdown, advertising the Mental Health Support Teams (Mhst) provision – and having a clear referral plan. West Bridgford Infant School is proud of their family ethos and the importance of knowing every child and their family. They hold strongly to the principle that good mental health is essential in order for children to access learning. Having a member of the Senior Leadership Team as Mental Health Lead was key to ensuring that emotional health and wellbeing is always part of school development plans and embedded in the school’s ethos. This has meant
Promoting children and young people’s mental health and wellbeing
that talking about thoughts, feelings and behaviour and strategies to manage strong or uncomfortable feelings is normalised.
Promoting children and young people’s mental health and wellbeing
Chapter 2: Ethos and environment
The physical, social and emotional environment in which staff, pupils and students spend a high proportion of every weekday has been shown to affect their physical, emotional and mental health and wellbeing as well as impacting on their attainment and behaviour (17).
The DfE Respectful School Communities tool supports schools to develop a whole school approach that promotes a culture of respect, and the tool sets out what is needed to achieve this (18). Guidance also recognises the importance of an individualised response to pupil or student needs, when behaviour might be a result of educational, mental health, other needs, or vulnerabilities, such as special educational needs and disabilities (8). Taking a trauma- informed approach can help contribute towards creating a safe environment for those who have experienced trauma and adverse experiences.
Relationships between staff and pupils, and between students, are critical in promoting wellbeing and in helping to engender a sense of belonging to and liking of school or college (18).
The special educational needs and disability (SEND) code of practice provides statutory guidance and practical advice for local authorities, health bodies and education settings on how to carry out the duty to provide for those with special educational needs under part 3 of the Children and Families Act 2014 (19). The 2014 SEND reforms also included a change from the characterisation of Behaviour, Emotional and Social Development needs to Social, Emotional and Mental Health Needs. Resources to support children and young people with learning disabilities, physical disabilities and chronic illness can be found at the end of the document. Key question: How does the school or college’s culture promote respect, inclusivity and value diversity?
Practice examples
At Epsom Downs Primary School, the children are taught to embrace and value difference and this is incorporated into the curriculum wherever possible. The school takes an active role in anti-bullying week and children from across the key stages take part in workshops and activities to teach them to address diversity in a positive way. At Squirrel Hayes First School, it was identified that the unstructured times of the school day such as break and lunchtime often presented the most challenge for many of the school’s
Promoting children and young people’s mental health and wellbeing
learners. Work was done to capitalise on this time within the school day to develop opportunities to model and teach key social skills. A variety of clubs were made available to all learners such as games, construction, craft and keep fit, which encouraged and promoted cooperative learning and positive social interactions. These clubs were run by teachers and teaching assistants who modelled and promoted successful strategies in aspects such as managing conflict, self-regulation and building effective relationships.
Promoting children and young people’s mental health and wellbeing
Chapter 3: Curriculum, teaching and learning School and college based programmes of social and emotional learning have the potential to help young people acquire the skills they need to make good academic progress as well as benefit pupil health and wellbeing (1). Opportunities exist to develop and promote social and emotional skills through a dedicated Personal Social Health and Economic education (Pshe) curriculum – including statutory content regarding Relationships Education (Re) and Relationships and Sex Education (Rse) and Health Education. Statutory guidance on the implementation of the curriculum states that such content should be delivered in a ‘carefully sequenced way, within a planned programme of lessons’ (7). As part of the Health Education curriculum, all pupils will be taught about mental health. By the end of primary school, pupils are expected to be able to recognise what is normal and what is an issue in themselves and others and, when issues arise, know how to seek support as early as possible from appropriate sources. By the end of secondary school, students should understand how they are feeling and why; to further develop the language that they use to talk about their bodies, health and emotions; and to understand where normal variations in emotions end, and health and wellbeing issues begin.
Other parts of the wider curriculum can complement Pshe or Rse and Health Education such as lessons in physical education, the arts and citizenship, and tutorials. The Pshe Association has published advice for teachers on teaching about mental health and wellbeing as part of the Rse and Health Education aspects of the Pshe curriculum. DfE has also produced a training module for teachers to support the teaching of physical health and mental wellbeing as part of this curriculum. Pupils are more likely to engage in lessons that focus on emotional wellbeing if they are of practical application and relevant to them. There are a range of ways of getting insights into pupil need ranging from validated assessment tools (see page 22) to feedback from existing forums such as school councils or local area youth councils. Assessment of learning is important and both teachers and pupils will want to know that what has been taught has been learnt, and that learning is progressing.
There may be stages during the academic year that provide opportunities for a specific curricular focus, for example learning skills for coping with transition periods or learning skills for coping with the pressures of studying for exams. There may also be times when it will be appropriate for a focus to be given to a locally topical issue.
Promoting children and young people’s mental health and wellbeing
Examples of resources that can be used to support the curriculum, teaching and learning can be found in the resources section at the end of the document. This includes cross-phase resources and resources for primary and secondary schools, and for further and higher education. Key question: What focus is given within the curriculum to social and emotional learning and promoting personal resilience, and how is learning assessed?
Practice examples
The Penn Resilience Programme (Prp) is an 18-lesson curriculum for 11 to 13 year olds, which supports young people to develop skills such as emotional intelligence, flexible and accurate thinking, self-efficacy, assertive communication and problem solving (20). The programme is intended to empower young people to be more resilient in dealing with setbacks and make the most of opportunities both inside and outside of school. The programme was initially piloted by 3 local authorities in England. The evaluation of the pilot found the programme had a positive impact on pupils’ application of skills to real life situations, a short- term improvement in depression symptom scores, school attendance rates and academic attainment in English and greater impact for the most vulnerable groups.
Healthy Minds is a research study that was funded by the Education Endowment Foundation and led by Bounce Forward. The project implemented a scheme of lessons which use cognitive behavioural theories to improve pupils’ wellbeing, resilience and motivation. The lessons were taught once a week by trained teachers for 4 school years from year 7 up to GCSE. Academic and health outcomes were used to understand the impact and measured against pupils who had not been taught Healthy Minds lessons, but Pshe ‘as usual’. The London School of Economics (Lse) led the research into the health and behaviour outcomes and the National Institute of Economic and Social Research (Niesr) led the academic outcomes. The largest ever study of its kind shows the impact of good quality teaching and learning on important outcomes. The Healthy Minds curriculum is now available to all schools.
At Squirrel Hayes First School, many of the learners have complex individual needs and face a number of social, emotional and behavioural challenges. In response to a high number of previous fixed term exclusions and external challenges facing a number of learners, it was recognised that a greater emphasis needed to be placed upon the wellbeing and mental health of the learning community as well as high academic aspirations. Mental health and wellbeing is now a vital part of the everyday curriculum and is embedded within all aspects of the school’s work. At the heart of the whole school approach lies the school’s commitment to knowing and
Promoting children and young people’s mental health and wellbeing
valuing each individual and their needs. The use of wellbeing questionnaires along with staff’s knowledge of our learning community, helps to co-ordinate and target their additional provision and the focus of any support required. All learners are encouraged to develop a Growth Mind set and use their Building Learning Power (Blp) skills of Resourcefulness, Reciprocity, Resilience and Reflectiveness to underpin their daily decision making and attitudes to their learning.
Pupils at Squirrel Hayes First School have weekly access to explicitly taught lessons on mental health, wellbeing and healthy lifestyles. Fitness Friday’s are popular with all who enjoy participating in a range of active and creative learning opportunities which promote wellbeing and maintaining a healthy mind and lifestyle. Use of weekly Rse lessons, dovetailed with Seal (Social Emotional Aspects of Learning) assemblies and ‘thoughts for the week’ ensures that all members of the learning community have a voice and regularly get the opportunity to discuss their wellbeing and ownership of this.
Wellington College has been teaching wellbeing lessons since 2006. Pshe lessons were overhauled in order to effectively engage students. A 60-hour programme embedded over a 4- year period has been developed focussed on enabling students to flourish. Students embark upon this course in year 9 when they arrive at the school and complete it at the end of their lower sixth form year. The Pshe Association has produced a number of resources to help schools incorporate emotional health and wellbeing into Pshe education lessons. YoungMinds suggests some simple and practical ways of incorporating emotional wellbeing into the curriculum. School Zone offers curriculum-linked, Pshe Association-accredited resources and inspiration for teachers, from Change4Life resources on nutrition and physical activity for primary teachers to Every Mind Matters mental health and wellbeing resources which are endorsed by the NHS, and lesson plans for secondary and Year 6 teachers.
Promoting children and young people’s mental health and wellbeing
Chapter 4: Student voice Involving students in decisions that impact on them can benefit their mental health and wellbeing by helping them to feel part of the school, college and wider community and to have some control over their lives. At an individual level, benefits include helping students to gain belief in their own capabilities, including building their knowledge and skills to make healthy choices and developing their independence. Collectively, students benefit through having opportunities to influence decisions, to express their views and to develop strong social networks. Key question: How does the school or college ensure all students have the opportunity to express their views and influence decisions?
Practice examples
St Albans Youth Council (Sayc), works alongside and presents its concerns to the district council. Following a number of suicides in the area, Sayc conducted a survey of 1,800 year 8 and year 10 students from schools in the district and a follow-up survey of 2,700 people, which included students and teachers. It identified high levels of stress in students with some requiring support for more serious mental health issues. Many of these students did not know about school-based counselling and indicated that they would approach their teacher if they needed support for a personal issue. The Sayc was so concerned about the high levels of mental health need and the funding difficulties of a local youth counselling service that it presented a letter to the district council asking it what it was going to do to prevent suicides in local young people. As a result of this the district council set aside £15,000 of ring-fenced money to promote mental health and wellbeing. This ring-fenced money was used to promote workshops focussed on the 5 ways to wellbeing.
The Haven is an integrated health centre that is co-located and managed by Budehaven Community School. There is a student management group which has representation from young people of all ages, including sixth formers. Involving young people in this way helps to give them ownership of the centre. The student management group was involved in setting-up and running the Haven. It was heavily involved in designing the Haven and was instrumental in obtaining funds to furnish the building. This has resulted in the service being very young person friendly, which encourages students to access it.
Promoting children and young people’s mental health and wellbeing
Framwellgate School Durham sees emotional wellbeing as a key factor in enabling students to achieve their full educational potential and to become responsible individuals well prepared for life beyond school. It has peer mentoring schemes and anti-bullying ambassadors. It has commissioned a social enterprise to run inspirational workshops with the students which focus on personal, social and employability skills. Evaluation of the work demonstrates that it has helped students gain an insight into why they behave in the way they do, and has made them more confident, and more empathic. School Zone offers curriculum-linked, Pshe Association-accredited resources and inspiration for teachers, from Change4Life resources on nutrition and physical activity for primary teachers to Every Mind Matters mental health and wellbeing resources which are endorsed by the NHS, and lesson plans for secondary and Year 6 teachers.
Promoting children and young people’s mental health and wellbeing
Chapter 5: Staff development, health and wellbeing Promoting staff health and wellbeing is an integral principal of the whole school or college approach to mental health and wellbeing.
Teaching and learning establishments can go some way in demonstrating a commitment to staff health and wellbeing in a number of ways. This can include providing opportunities for assessing the mental health and wellbeing needs of staff, by providing support to enable staff to reflect on and to take actions to enhance their own wellbeing and by promoting a work-life balance for staff.
A good way of driving these changes is through the Workplace Wellbeing Charter National Standards. The standards set out action across a number of areas, including mental health and wellbeing, and provide a roadmap for driving improvements in workplace health.
DfE has developed an education staff wellbeing charter, which sets out commitments to the wellbeing and mental health of everyone working in education. The charter also encourages measurement of staff wellbeing to monitor and respond to any changes (21).
Education Support are a charity dedicated to improving the health and wellbeing of the education workforce and provide a host of resources to support education staff. The Better Health Every Mind Matters website includes a self-care tool to help staff to take simple steps to look after their mental health and find a good work-life balance. It is important for staff to access training to increase their knowledge of mental health and wellbeing and to equip them to be able to identify mental health difficulties in their students and know what to do should they have a concern. DfE has produced guidance to help settings to support the mental health and wellbeing of children and young people, as well as providing advice and guidance on working with other professionals and external agencies and setting out the additional support available to schools (10).
Public Health England’s Psychological First Aid training can be accessed by teachers in supporting the psychological wellbeing of children and young people affected by an emergency or crisis (22). The government has also funded an e-learning platform developed by experts in children and young people’s mental health and emotional health and wellbeing called MindEd.
The Charlie Waller Trust provide e-learning resources specifically for Further Education Colleges.
Promoting children and young people’s mental health and wellbeing
Information on further training opportunities for school staff on mental health and wellbeing can be found in the resources section. Key question: How are staff supported in relation to their own health and wellbeing and to be able to support student wellbeing?
Practice examples
Bristol University is undertaking a research project that is looking at the effects of providing school staff with support for their wellbeing via a peer support service, and training in supporting student wellbeing using Youth Mental Health First Aid (Mhfa). The project is called Wellbeing in Secondary Education (Wise). The Islington Child and Adolescent Mental Health Service (CAMHS) offer all schools the ‘Solihull Approach Training’ (23) which gives school staff a framework to help them work with children and parents and gives them a better understanding of mental health issues and how they can help support their students. The training also gives schools a shared language with the NHS Children and young people's mental health services (Cypmhs) workers which helps support integrated working.
Promoting children and young people’s mental health and wellbeing
Chapter 6: Identifying need and monitoring impact
Identifying pupil and student need on a more formal basis can help to inform commissioning decisions at school level, across clusters of schools and colleges or at a local authority level. It can also assist in recording and monitoring the impact of any support that is put in place. There are a variety of tools that education settings can use as the basis for understanding and planning a response to pupils’ and student mental health and wellbeing needs. The tools range from simple feedback forms to validated measures which can focus on both wellbeing and mental health. Mentally Healthy Schools signposts to a toolkit for schools and colleges on measuring and monitoring the wellbeing of the pupil population.
Examples of validated tools that can measure mental wellbeing include: • the Stirling children’s wellbeing scale, a holistic and positively worded scale, developed by the Stirling Educational Psychology Service, that is suitable for educational professionals looking to measure emotional and psychological wellbeing in children aged 8 to 15 years • the Warwick-Edinburgh mental wellbeing scale (Wemwbs) is also a positively worded scale that can be used to measure wellbeing with young people aged 13 and over, and is recommended that it be used with samples of over 100 people
The Education Endowment Fund hosts the Spectrum (Social, Psychological, Emotional, Concepts of self, and Resilience: Understanding and Measurement) database. This is populated with a review of concepts and measures derived from a systematic review that is focussed on how to define and measure various aspects of social and emotional development. For tools, such as the strengths and difficulties questionnaire (Sdq), designed to focus more on assessing targeted and specialist mental health needs, please see DfE Guidance (9).
Promoting children and young people’s mental health and wellbeing
Key question: How does the school or college assess the needs of students and the impact of interventions to improve wellbeing?
Practice examples
Epson Downs Primary School uses happy/sad sheets to enable lunchtime staff and class teachers to track emotional wellbeing and look for signs of bullying or withdrawal. The school provides a range of support for children from assigning them a lunchtime buddy to providing a ‘Circle of Friends’ intervention (24) a team of support, primarily peer support around the child, and via its ‘Nurture Room’k service. Smithy Bridge Primary School in Rochdale used an adapted version of the Stirling Wellbeing Scale to measure wellbeing in year 6 students. It used its data to evaluate how well new activities and interventions designed to improve wellbeing were actually working and whether they were worth the investment.
Framwellgate School Durham was able to demonstrate to its governors that its counselling service enhanced the motivation of students, impacted positively on their attendance and learning, and as such improved standards. This enabled the school to invest in further developing the counselling service. Through their ‘Shining Brightly’ themes, West Bridgford Infant School use their superhero characters, stories and videos to explicitly teach children how to develop healthy habits. Teachers are expected to monitor and discuss children’s emotional health and wellbeing as part of Pupil Progress Reviews. This has led to them raising concerns early with the Mental Health Lead in the school in the same way as they would a safeguarding concern. Place2Be uses well-researched measures to assess how its services are improving children’s emotional wellbeing. This data is used to evaluate how well a commissioned service or other intervention is working and whether it is actually helping pupils and students.
k A nurture room is a small structured teaching group for students showing signs of behavioural, social or emotional difficulties, particularly those who are experiencing disruption or distress outside of school.
Promoting children and young people’s mental health and wellbeing
Chapter 7: Working with parents, families and carers The family plays a key role in influencing children and young people’s mental health and wellbeing (27). There is strong evidence that well implemented universal and targeted interventions supporting parenting and family life that offer a combination of emotional, parenting and practical life circumstances (combining drug, alcohol and sex education, for example) have the potential to yield social as well as economic benefits. Schools and colleges should ensure that the mental health and wellbeing support offer is clearly communicated with parents and carers. Where schools and colleges identify additional needs, they should work closely with the local authority to ensure parents and carers are aware of the wider support available to them in their local area. Signposting tools to support parents and carers can be found in the resources section at the end of the document. Key question: How does the school or college work in partnership with parents and carers to promote emotional health and wellbeing?
Practice examples
Kings Hedges Primary School has commissioned a service for parents called The Red Hen Project. This project is located within the school and is provided by a local charity. The project provides home-school workers who build relationships with families and work with the children in school and the family at home. It helps families to address issues such as attendance problems, bullying and family break-ups that may cause a barrier to learning. Centre for Mental Health has written a briefing for schools about the importance of parenting programmes.
Bounce Forward runs evidence informed interventions in the classroom and other settings to help young people and adults learn the skills of emotional resilience and wellbeing. Parent workshops are one key aspect of Bounce Forward’s work, helping parents to be role models for their children regarding how they deal with setbacks and develop resilient thinking.
At Ashfield School, including parents in communication is key; the school continue to develop their provision through collaboration with the Mhst and the offer of twilight sessions to allow parents to also learn about mental wellbeing for themselves and their children.
Promoting children and young people’s mental health and wellbeing
Chapter 8: Targeted support and appropriate referrals Some children and young people are at greater risk of experiencing poorer mental health. For example, those who are in care, young carers, those who have had previous access to NHS Cypmhs, those living with parents or carers with a mental illness and those living in households experiencing domestic violence. Delays in identifying and meeting emotional wellbeing and mental health needs can have far reaching effects on all aspects of children and young people’s lives, including their chances of reaching their potential and leading happy and healthy lives as adults (8).
There is good advice already available from DfE that focusses on the role of schools in providing targeted support and specialist provision for pupils with particular mental health and wellbeing needs (8,9,10). This document, therefore, purposefully does not duplicate these existing resources.
Transforming children and young people’s mental health provision introduced new Mental Health Support Teams, to work across schools and colleges within a local area to provide targeted support.l These teams are comprised of Education Mental Health Practitioners (EMHPs) alongside a range of other professionals. The teams provide early intervention support on some mental health and wellbeing issues, as well as supporting school and college staff to implement a whole school or college approach. Thirty-five per cent of pupils and students in England (almost 3 million) are expected to have access to a Mhst by 2023.
School and college based counselling is also an effective form of targeted support for pupils. The DfE blueprint for counselling provides advice for education leaders on setting up and improving counselling services in schools, and sets out practical, evidenced informed advice to ensure counselling achieves the best outcomes for children and young people.
School nurses and their teams have an important role to play in supporting the emotional and mental health needs of school-aged children and are equipped to work at community, family and individual levels. Their skills cover identifying issues early, determining potential risks and providing early intervention to prevent issues escalating (25, 26). Student feedback indicates how much they value the trusted adult role, face to face interaction and other support provided through school nursing teams.
l More information on where MHSTs are operating can be found here: NHS England » Transforming children and young people’s Mental Health Support Teams and pilots.
Promoting children and young people’s mental health and wellbeing
Resilience and emotional wellbeing is one of 6 High Impact Areas identified for school nursing, with guidance setting out what school nurses can do at an individual and family level, a community level and a population level (26, 27).
The Youth Wellbeing Directory helps service users and funders find high quality services to improve the emotional wellbeing and mental health of children and young people directly, or by supporting their families and caregivers. The directory enables users to search for services in their area and to have the reassurance that the services being promoted adhere to quality standards. Key question: How does the school or college ensure timely and effective identification of students who would benefit from targeted support and ensure appropriate referral to support services?
Practice examples
Samuel Rhodes Primary School is a special school in Islington that has set up a multidisciplinary team comprising of a speech and language therapist, occupational therapist, Cypmhs workers and a school support worker. This team meets regularly to share information and provide support including training for school staff. Framwellgate School Durham has a well-established counselling service and it views this provision as part of its duty of care to its students. The counsellors are employed by the local authority and the school buys in their service under a service level agreement. Kings Hedges Primary School has commissioned a local charity to provide a school based counselling service that provides one-to-one counselling and mentoring. Its work with young children uses a play and arts based approach to develop coping strategies which helps improve pupils’ school performance. Epsom Downs Primary School has invested in support from an external agency that delivers early intervention group support for key stage 1 children who have emotional and behavioural difficulties. This service provides support to all key stage 1 children from across the North Downs Confederation area. It also has a nurture room, which is a small structured teaching group for students showing signs of behavioural, social or emotional difficulties, particularly those who are experiencing disruption or distress outside of school. Nurture groups work with
Promoting children and young people’s mental health and wellbeing
individual children or small groups and provide targeted support. This service is run by 2 specially trained and experienced emotional literacy support assistants.
Complex cases at the Harbour School are discussed and planned in ways that better meet the individual’s emotional needs. The most complex cases are referred to senior leaders on a pupil placement panel who suggest ways forward. They also work with the multi-systemic team to help some of the hardest to reach and complex families. Budehaven Community School provides a wide range of services through its integrated health centre known as The Haven. These services include NHS Cypmhs, diabetic clinics, school nursing services and careers advice. Having services provided on the school site means that young people have easy access to the services they need with minimum disruption caused by taking time out of lessons to access the services and helping to reduce the stigma associated with accessing mental health support. At Squirrel Hayes First School, staff receive regular training and updates on key aspects which significantly impact upon the learning community such as ‘attachment, relationships building and self-regulation. The school works very closely with partners from other agencies such as the Mental Health Support Teams and Visyon counselling services to ensure that support can be offered when it is needed most. Through working with such partners, the school has implemented worry and anxiety scales across the school and have developed the use of a number of strategies such as the ‘5 to thrive’ to ensure a consistent approach to managing feelings, emotions and the behaviours which result from these. West Bridgford Infant School are proud to be one of the first primary schools to be part of the Mental Health Support Team Trailblazer Project. This has enabled the school to develop an excellent partnership with specialist practitioners. They have been able to provide workshops for children and parents and quickly access 1:1 or group support for children with low level mental health issues. They have also accessed training which has enhanced knowledge and given confidence when dealing with mental health issues. Walsall school nursing service uses the ‘Friends’ programme, which is an evidence informed cognitive behavioural programme. School nurse teams are trained to deliver programmes in schools and other venues, targeting children and young people with anxiety or low self-esteem and confidence. Sessions are co-facilitated with school staff, helping to build the capacity of the school to offer early intervention.
Promoting children and young people’s mental health and wellbeing
Resources Some local authority public health teams provide coordinated health and wellbeing support for teaching and learning providers. In some areas this includes helping schools and colleges to audit current whole school or college practice and identify priorities for continuing development, as well as helping schools and colleges to address the identified needsm. There is a wide range of resources and support available to help promote children and young people’s emotional health and wellbeing. The list below aims to signpost and categorise some of these sources based on insights from the Children and Young People’s Mental Health Coalition and feedback from individual schools and colleges. The list is not exhaustive, many other useful organisations and services exist and inclusion of resources in sections 4 to 9 does not constitute a recommendation from Phe or the Department for Education. The Pshe Association has a Quality Mark for Pshe education resources, to support teachers and schools in choosing safe and effective materials. All of the links listed below were correct at the time of publication 1. Government guidance and advice
Mental health and behaviour in schools (2018) is departmental advice for school staff. Department for Education. Counselling in schools: a blueprint for the future (2015) is departmental advice for school staff and counsellors. Department for Education. Preventing and tackling bullying (2017) advice for head teachers, staff and governing bodies. Department for Education. Promoting the health and wellbeing of looked-after children (2015) is statutory guidance for local authorities, clinical commissioning groups and NHS England. Department of Health and Department for Education. Keeping children safe in education (2014) is statutory guidance for schools and colleges. Department for Education. Supporting pupils at school with medical conditions (2014) is statutory guidance for governing bodies of maintained schools and proprietors of academies in England. Department for Education.
m Healthy Schools London, for example, has an audit tool that helps schools assess how well they are implementing a whole school approach, and prepare for an awards system.
Promoting children and young people’s mental health and wellbeing
Healthy child programme from 5 to 19 years old (2009, currently being updated) is a recommended framework of universal and progressive services for children and young people to promote optimal health and wellbeing. Department of Health. Health visiting and school nursing programme supporting implementation of the new service offer: promoting emotional wellbeing and positive mental health of children and young people Transforming children and young people’s mental health provision: a Green Paper (2017) sets out proposals to implement additional mental health support within schools and colleges. Department for Education and Department of Health. The Statutory Guidance for Rse and Health Education (2020) sets out guidance for schools and colleges when implementing this curriculum. Department for Education. The SEND code of practice: 0 to 25 years provides guidance for local authorities, education settings and health bodies on the SEND system for children and young people aged 0 to 25. Department for Education.
The Respectful School Communities self-review and signposting tool supports schools to develop a whole-school approach which promotes respect and discipline, in order to combat bullying, harassment and abuse of any kind.
Promoting children and young people’s mental health and wellbeing
2. Data
Public Health England’s Children and young people’s mental health and wellbeing profiling tool collates and analyses a wide range of publicly available data on risk, prevalence and detail (including cost data) on those services that support children with, or vulnerable to, mental illness. It enables benchmarking of data between areas. Health behaviour of school age children is an international cross-sectional study by the World Health Organization that takes place in 43 countries and is concerned with the determinants of young people’s health and wellbeing. NHS Digital Mental Health of Children and Young People in England survey provides the most up-to-data data on the prevalence of children and young people with mental health difficulties in England. Local public health teams operating from within the local authority may be able to provide insights into relevant local data sources. 3. Training
The Department for Education is offering a senior member of staff in every school or college the opportunity to get a grant for training to help the lead develop or introduce a whole school or college approach to mental health and wellbeing in their setting. MindEd is a portal that provides free, online bite sized chunks of eLearning available on tablets, phones or computers to help adults to identify, understand and support children and young people with mental health issues. Health Education England has produced a Public Mental Health Content Guide, which provides an introduction to public mental health for the workforce who have a role to play in improving public health. The Department for Education has created a training module available for school staff that supports the physical health and mental wellbeing section of the Rse and health education curriculum. Public Health England’s Psychological First Aid training offers training on how to provide practical and emotional support to children and young people affected by emergencies or crisis situations. Mental Health First Aid England is an educational course focussing on young people’s mental health and how to identify, understand and help a young person who may be developing mental health problems.
Promoting children and young people’s mental health and wellbeing
4. Curriculum resources
Cross-phase
Mental wellbeing | Overview | Phe School Zone helps educators teach Pshe, Rhe and Rshe to Upper KS2, KS3 and KS4 students, with flexible, ready to use resources featuring topics such as sleep, worry and building connections, co-created with teachers and young people. Teaching about relationships, sex and health - provides support and training materials for schools, to help train teachers on relationships, sex and health education. Pshe Association helps support Pshe practitioners across all phases to raise the quality of Pshe teaching. This includes guidance on teaching about mental health and emotional wellbeing. Mentally Healthy Schools brings together quality assured mental health resources, information and advice for schools and education settings. MindEd provides an education hub which hosts information for education staff on supporting children’s mental health and wellbeing, as well as more in depth content covering wellbeing resilience, bereavement, and stress.
YoungMinds provides resources aimed at both primary pupils and secondary school students. They have also produced a worksheet to help pupils express their feelings and understand what may have triggered them. Headspace for Educators offers educators access to free mindfulness and meditation exercises and resources for every age group. Primary age
Feeling good: promoting children’s mental health are activity sheets aimed at children aged 4 to 7 produced by the Centre for Mental Health. How to get up and go when you are feeling low is a booklet by the Evidence Based Practice Unit at the Anna Freud Centre, providing top tips for year 4 students when they are feeling upset or stressed.
Promoting children and young people’s mental health and wellbeing
Secondary age
Time to change provides a collection of resources including videos, lessons, assemblies, and toolkits for teachers and youth workers to reduce stigma and discrimination faced by people with mental health problems. What’s on your mind? is a resource pack that includes a video along with downloadable lesson plans to help teachers introduce the subject of emotional wellbeing and mental health to students. Produced by the Scottish anti-stigma programme ‘See Me’. Notes to self is a film and mental wellbeing teaching resource for use with young people at key stages 3 to 5. It helps students get a better understanding of mental health issues and why they should seek help. The film and teaching pack cost £35, but the trailer is freely available online. Further and higher education
The Association of colleges have created a Mental Health and Wellbeing Charter for colleges across England to reaffirm their commitment to staff and student mental health and wellbeing. The Association of Colleges has also created a resource pack on supporting student mental health and wellbeing for college leaders.
The University Mental Health Charter provides a set of principles to support universities across the UK in making mental health a university wide priority. The Wellbeing Thesis is an online resource for postgraduate students to support their wellbeing, learning and research. 5. Examples of organisations providing mental health and wellbeing support for schools and colleges
Achievement for All (AfA) delivers a whole school improvement framework that raises the aspirations, access and achievement of vulnerable and disadvantaged pupils, including those with special educational needs and disabilities, English as an Additional Language (Eal), looked-after children and children on free school meals. The programme has 4 elements: leadership, teaching and learning, parental engagement, and wider outcomes.
AcSEED encourages all UK schools to achieve and maintain an acceptable threshold of support and to align on best practices that provide a common language and
Promoting children and young people’s mental health and wellbeing
understanding between schools, parents, young people, and associated organisations and charities. The AcSEED initiative was founded by young people with direct personal experience of mental illness at a young age and is entirely dedicated to supporting the emotional wellbeing and mental health of young people in schools. Anna Freud has developed a 5 Steps Framework to help schools and colleges develop their approach to mental health and wellbeing. Nurture UK promotes the development of ‘nurture groups’ that are small groups of children who need short, focussed support to help address issues connected to social, emotional and behavioural difficulties. It ensures the continuing quality of delivery through accredited training programmes, research on effective practice, relevant publications and information exchange. The National Children’s Bureau (Ncb) hosts The Schools Wellbeing Partnership. This is a network of nearly 50 member organisations who work to improve the wellbeing of all children in education. The Partnership provides useful free resources for schools, including information on implementing a whole school approach. The Ncb also hosts a Wellbeing Schools Forum: an online forum for policy updates, peer support and for schools and teachers to share best practice around mental health and wellbeing for their pupils. Ncb operate a Wellbeing Award for Schools to support schools to deliver a whole school approach. Academic Resilience from YoungMinds is a free resource to help schools support pupils’ academic resilience and was devised by Lisa Williams and Professor Angie Hart. Samaritans can support schools by giving talks, providing a teaching resource called Deal, and hosting a suicide response service to support schools following a suicide. The YoungMinds website also provides a useful library of resources for schools. Therapeutic story writing from YoungMinds is an approach to helping support students’ emotional wellbeing whilst at the same time improving writing skills. 6. Resources to support children and young people with learning disabilities, physical disabilities and chronic illness
Children and young people with learning disabilities: understanding their mental health is an information pack providing an introduction to learning disabilities among children and young people, produced by Mental Health Foundation.
Promoting children and young people’s mental health and wellbeing
Friends for life: learning disabilities is part of Friends for Life, a group programme that teaches children and young people techniques to cope with anxiety and promote wellbeing, social and emotional skills and resilience. The Friends for Life Learning Disabilities development project was adapted to be accessible for children and young people with learning disabilities. Feeling down: looking after my mental health is an easy read guide for people with learning disabilities from the Foundation for People with Learning Disabilities. The guide provides information and advice on how to look after oneself and get the best out of life. I Can produces factsheets about speech, language and communication difficulties, and has a helpline for parents and practitioners. National Autistic Society has a website that provides information about autism. The SEND Gateway provides information for professionals, containing resources on responding appropriately to children and young people with SEND with emotional wellbeing needs. 7. Resources for specific issues
Childhood bereavement network offers resources to help schools deal with a bereavement within the school. Ocd Youth website is especially for young people, their parents and teachers with information, resources, and online forums for young people with Ocd. On edge: self-harm awareness resource pack is a film and lesson plan resource pack for teachers and other professionals working with young people. Developed by NHS Greater Glasgow and Clyde. The Government tool Respectful school communities is a tool to support school staff to combat bullying, harassment and abuse of any kind. The Anti-Bullying Alliance provides free online training for schools and teachers and has advice for parents and carers about bullying. Beat provides advice and support on eating problems and disorder, with general downloads and resources and advice for school and college teachers and staff. Papyrus (Prevention of Young Suicide) provides confidential advice and support for young people who feel suicidal and has published a guide for teachers and staff.
Promoting children and young people’s mental health and wellbeing
Operation Encompass Teachers’ helpline is staffed by educational psychologists to support staff working with children and young people at risk of or experiencing domestic abuse. 8. Helplines and resources for young people
Nspcc Working with schools is a service that uses specially trained volunteers to talk to primary school children about abuse. The aim is to give them the skills to protect themselves and know where to go for help. There is also a free helpline for children and young people. The helpline number is 0800 1111. Get Connected is a free, confidential helpline service for young people under 25, who need help, but don’t know where to turn. The helpline number is 0808 808 4994. Papyrus is a charity that aims to prevent young suicides. It has a helpline for young people at risk of suicide or for people worried about a young person at risk of suicide called HOPELineUK. The helpline number is 0800 068 41 41. Relate provides local counselling services for all ages including young people. It also has an online emotional support and advice resource called IRelate which provides information and access to an online counsellor. Shout 85258 is a free, confidential, 24/7 text messaging support service for anyone who is struggling to cope. Student Space provides support, advice and guidance to students and helps students to find support services that are available at their university. Student Health App provides easy access to more than 900 pages of reliable health information all in one place. The app aims to help reduce worries and to provide support to students when they need it most. The Mix provides an online support section for young people to get advice and support. Young people can speak through an online chat or can call their helpline. Youth Access offers a directory of local youth information, advice and counselling services for young people aged 14 to 25. Youth Health Talk provides advice and support on mental health issues from young people for young people.
Promoting children and young people’s mental health and wellbeing
9. Parenting programmes and support for parents and carers
Childhood behaviour problems: briefings for professionals is by the Centre for Mental Health. Some of the best tested and most reliable parenting programmes are Incredible Years and Triple P. In order to work best, parenting programmes need to be delivered as they were originally intended and be targeted at those with the right level of need. YoungMinds Parents’ Helpline is a free, confidential helpline for any adult who is concerned about the emotional problems, behaviour or mental health of a child or young person up to the age of 25. The helpline number is 0808 802 5544. Square Peg provides support for parents or carers whose children struggle to go to school
Promoting children and young people’s mental health and wellbeing
Appendix National and local policy context
Transforming Children and Young People’s Mental Health
The government’s green paper Transforming Children and Young People’s Mental Health (28) sets out 3 commitments to improve children and young people’s mental health, with an emphasis on partnership working between Health and Education. The commitments include:
1. The introduction of mental health support teams (MHSTs) in 20% to 25% of schools and colleges by 2023/2024. 2. Training for senior mental health leads to support embedding of an integrated, positive mental health ethos in educational settings. 3. Pilots for a 4-week waiting time for children and young people’s mental health services.
MHSTs include newly trained Education Mental Health Practitioners working alongside other established workforces such as educational psychologists, school nurses and education welfare officers, providing support for the mental health needs of children and young people in primary, secondary and further education (ages 5 to 18). MHSTs also liaise with external specialist services to help children and young people to get the right support and stay in education. This includes working as part of an integrated referral system with community and specialist services to facilitate access to appropriate support. MHSTs support staff in schools and colleges to provide a whole school or college approach to mental health and wellbeing, building resilience, supporting early intervention and enabling appropriate signposting and delivery of evidence-based support, care and interventions. The Department for Education has published guidance on promoting and supporting mental health and wellbeing in schools and colleges (30) and on senior mental health lead training (31). Statutory Rse and Health Education
From September 2020 Relationships Education, Relationships and Sex Education (Rse) and Health Education became statutory (7) including a requirement for pupils and students to learn how to recognise the early signs of mental wellbeing concerns, including common types of mental ill health, and where and how to seek help with concerns about mental wellbeing. A mental wellbeing teacher training module (32) has been published to help subject leads and teachers understand what they should teach, as well as improving their confidence in delivering mental wellbeing as part of the new curriculum.
Promoting children and young people’s mental health and wellbeing
Link Programme
The Link Programme aims to help local areas improve joint working between local NHS mental health services, schools and colleges, local specialist NHS Cypmhs, local authorities and voluntary and community sector services. The link programme is complementary to the Mental Health Support Teams who are also set up to provide ongoing support to schools and colleges as they develop, support education settings leads to embed a whole school or college approach for mental health and improve links with mental health services. Wellbeing for Education Recovery
The Wellbeing for Education Recovery programme is intended to help local areas to support schools and further education providers to promote wellbeing and good mental health, responding to the impacts of the COVID-19 pandemic. The initiative comprises training materials and funding for local experts to adapt and support delivery of training and resources into all schools and colleges in each local area, and ongoing support, until the end of Spring Term 2021. Psychological First Aid Training
This is available online and is designed to assist professionals, volunteers, and members of the public in supporting the psychological wellbeing of children and young people aged 0 to 25 affected by an emergency or crisis event (including being relevant in the context of the COVID- 19 pandemic) (22). Better Health - Every Mind Matters
Every Mind Matters is a social marketing campaign that aims to inform and equip children, young people and adults to look after their mental wellbeing, via an NHS endorsed website, digital tools and classroom tools, developed in partnership with clinical and academic experts. School Zone offers curriculum-linked, Pshe Association-accredited resources. This includes mental health and wellbeing resources (endorsed by the NHS) and lesson plans for secondary schools and Year 6. Health and Wellbeing Boards
At a local level Health and Wellbeing Boards have a key role in overseeing the local provision of mental health and wellbeing support. This board brings together representation from the local authority and the Clinical Commissioning Group and includes representation from Education. The Prevention Concordat
The Prevention Concordat for Better Mental Health (33) promotes the use of prevention-focused approaches to improving mental health. The concordat is intended to provide a focus for cross-
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sector action to deliver an increase in the adoption of public mental health approaches across services.
Promoting children and young people’s mental health and wellbeing
References
1. Durlak Ja and others. ‘The impact of enhancing students’ social and emotional learning: A meta‐analysis of school‐based universal interventions’ Child development 2011: Volume 82, issue 1, pages 405-432 2. Public Health England. ‘The link between pupil health and wellbeing and attainment’ 2014. (viewed 14 July 2021). 3. Department of Health. ‘Annual report of the chief medical officer: public mental health priorities: investing in the evidence’ 2013 4. Nice. ‘Social and emotional wellbeing in primary education’ London: 2008 5. Nice. ‘Social and emotional wellbeing in secondary education’ London: 2009 6. Department for Education. ‘Supporting pupils at school with medical conditions: statutory guidance for governing bodies of maintained schools and proprietors of academies in England’ London: 2014 (Updated August 2017) 7. Department for Education. ‘Relationships Education, Relationships and Sex Education (Rse) and Health Education’ London: 2019 8. Department for Education and Department of Health. ‘Promoting the health and wellbeing of looked-after children: statutory guidance for local authorities, clinical commissioning groups and NHS England’ London: 2015 9. Department for Education. ‘Mental health and behaviour in schools: Departmental advice for school staff’ London: 2018 10. Department for Education. ‘Counselling in schools: a blueprint for the future: departmental advice for school staff and counsellors’ London: 2015 (Updated February 2016) 11. NHS Digital. ‘Mental health of children and young people in England, 2020: Wave 1 follow up to the 2017 survey’ NHS Digital: 2020 (Viewed 14 July 2021) 12. Public Health England. ‘COVID-19 mental health and wellbeing surveillance report, Chapter 7: Children and young people’ London: 2021 13. Department for Education. ‘Keeping children safe in education’ London: 2021 (Viewed 16 July 2021) 14. Department for Education, Department of Health. ‘Transforming children and young people’s mental health provision: a Green Paper’ London: 2017 15. Langford R and others. ‘The Who Health Promoting School framework for improving the health and well‐being of students and their academic achievement’ Cochrane database of systematic reviews 2014: volume 4 16. Weare, K. ‘What works in promoting social and emotional wellbeing and responding to mental health problems in schools? Advice for schools and framework document’ London: National Children’s Bureau 2015 17. Cemalcilar Z. ‘Schools as socialisation contexts: Understanding the impact of school climate factors on students’ sense of school belonging’ Applied psychology 2010: volumw 59, issue 2, pages 243-272 18. Department for Education. ‘Respectful School Communities Self Review and Signposting Tool’ 2018 (viewed 14 July 2021)
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19. Department for Education and Department of Health and Social Care. ‘SEND code of practice: 0 to 25 years’ London: 2014 20. Challen A, and others. ‘UK resilience programme evaluation: Final report’ London: Department for Education: 2011 21. Department for Education. ‘Education staff wellbeing charter’ London: 2021 22. Public Health England. ‘Psychological first aid in emergencies training for frontline staff and volunteers’ 2020 (viewed March 2021) 23. The Solihull Approach. ‘Understanding your child’ (viewed 14 July 2021) 24. The National Autistic Society. ‘Circle of friends: promoting inclusion and interaction’ (viewed March 2021) 25. Public Health England. ‘Healthy Child Programme 0 to 19: health visitor and school nurse commissioning’ 2021 (viewed March 2021) 26. Department of Health, Public Health England. ‘Health visiting and school nurse programme: supporting implementation of the new service offer: Promoting emotional wellbeing and positive mental health of children and young people’ London: 2014 27. Public Health England. ‘Supporting public health: children, young people and families’ 2021 (viewed 14 July 2021) 28. Department of Health and Social Care, Department for Education. ‘Government Response to the Consultation on Transforming Children and Young People’s Mental Health Provision: a Green Paper and Next Steps’ London: 2018 (viewed 16 July 2021) 29. Ofsted. ‘School inspection handbook’ London: 2021 (viewed July 2021) 30. Department for Education ‘Promoting and supporting mental health and wellbeing in schools and colleges’ London: 2021 31. Department for Education ‘Senior mental health lead training guidance’ London: 2021 32. Department for Education ‘Teaching about mental wellbeing’ London: 2020 33. Public Health England ‘Prevention Concordat for Better Mental Health’ London: 2017
Published September 2021 Phe gateway number: GW-8973
www.gov.uk/phe Twitter: @PHE_uk www.facebook.com/PublicHealthEngland © Crown copyright 2021 This document was first published in 2015. It has been updated to reflect new policy and data.
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