Supporting Mental Health in schools

This page provides information on how you can support children and young adults experiencing mental health difficulties and when a mental health difficulty can be considered a disability or Special Educational Need.

This guidance applies to both maintained schools and academies

In order to help pupils succeed, schools have a role to play in supporting them to be resilient and mentally healthy. There are a variety of actions that Schools can implement, for all their pupils and for those with particular problems, to offer that support in an effective way.

Examples of Mental Health Problems

Children can experience a range of emotional and behavioural problems that are outside the normal range for their age or gender. These children and young people could be described as experiencing mental health problems or disorders. 

Mental health professionals have defined these as:

• Emotional disorders, e.g. phobias, anxiety states and depression; 
• Conduct disorders, e.g. stealing, defiance, fire-setting, aggression and antisocial behaviour; 
• Hyperkinetic disorders, e.g. disturbance of activity and attention;  
• Developmental disorders, e.g. delay in acquiring certain skills such as speech, social ability or bladder control, primarily affecting children with autism and those with pervasive developmental disorders; 
• Attachment disorders, e.g. children who are markedly distressed or socially impaired as a result of an extremely abnormal pattern of attachment to parents or major care givers; 
• Psychotic disorders e.g. schizophrenia and manic depressive disorder.

Identifying a Mental Health Difficulty

Only medical professionals should make a formal diagnosis of a mental health condition. Schools, however, are well-placed to observe children day-to-day and identify those whose behaviour suggests that they may be suffering from a mental health problem or be at risk of developing one.

Government guidance has proposed a two-step approach that’s Schools can exercise in determining and identifying children at risk of mental health problems:

• effective use of data so that changes in pupils’ patterns of attainment, attendance or behaviour are noticed and can be acted upon; and 
• an effective pastoral system so that at least one member of staff knows every pupil well and can spot where bad or unusual behaviour may have a root cause that needs addressing. Where this is the case, the pastoral system or school policies should provide the structure through which staff can escalate the issue and take decisions about what to do next.

Early identification and prompt help ensure that problems can be resolved with minimal disruption. Early intervention prevents initially more minor mental health problems from escalating and significantly reduces the need for more expensive interventions or sanctions at a later stage

Government guidance provides several examples of risk factors which should place a School on alert with respect to a child’s mental health:

• Bullying 
• Discrimination 
• Breakdown in or lack of positive friendships 
• Deviant peer influences 
• Peer pressure 
• Poor pupil to teacher relationships

Children with Special Educational Needs

Persistent mental health difficulties may lead to pupils having significantly greater difficulty in learning than the majority of those of the same age. Schools should consider whether the child will benefit from being identified as having a special educational need (SEN).

When deciding whether a pupil has SEN, schools should use the definition of SEN used in the SEND Code of Practice: 0 to 25 years. This states: 

A child or young person has SEN if they have a learning difficulty or disability which calls for special educational provision to be made for him or her. 

A child of compulsory school age or a young person has a learning difficulty or disability if he or she: 

• has a significantly greater difficulty in learning than the majority of others of the same age, or
• has a disability which prevents or hinders him or her from making use of educational facilities of a kind generally provided for others of the same age in mainstream schools or mainstream post-16 institutions.

Can mental health difficulties be considered a disability?

Some children suffering with mental health problems can be considered disabled under the Equality Act 2010. All schools are under an obligation not to discriminate against pupils on the grounds of disability. Under the Act disability includes a mental impairment. The mental impairment must have a substantial and long-term adverse effect on the person’s ability to carry out normal day-to-day activities.

If a child or young person falls within the definition of disability above then the school has particular obligations. Schools are under a duty to make reasonable adjustments to put disabled students on a more equal footing with pupils without disabilities. 

What can the School do to address mental health issues?

The whole-school approach

‘Whole School’ refers to a multi-component holistic approach, which mobilises the whole School community, to promote social and emotional well-being.

This approach is not necessarily tangible, but refers to an ethos which underlies every aspect of School life.   

Public Health England has released a framework to clarify understanding of the term ‘whole school’ approach. Their understanding is underpinned by eight fundamental principles:

• Leadership and management that supports and champions efforts to promote emotional health and wellbeing and that sets a culture within the school that values all pupils
• An ethos and environment that promotes respect and values diversity. This includes clear policies on behaviour and bullying that set out the responsibilities of everyone in the school and the range of acceptable and unacceptable behaviour for children
• Curriculum teaching and learning to promote resilience and support social and emotional learning. 
• Enabling student voice to influence opinions. 
• Staff development that makes it clear that promoting good mental health is the responsibility of all members of school staff and community, informs them about the early signs of mental health problems, what is and isn’t a cause for concern, and what to do if they think they have spotted a developing problem;
• Identifying need and monitoring impact of interventions. This should include an assessment to establish a clear analysis of the pupil’s needs; a plan to set out how the pupil will be supported; action to provide that support; and regular reviews to assess the effectiveness of the provision and lead to changes where necessary;
• Working with parents/carers and ensuring their opinions and wishes are taken into account and that they are kept fully informed so they can participate in decisions taken about them
• Targeted support and appropriate referral. Schools should work closely with other professionals to have a range of support services that can be put in place depending on the identified needs (both within and beyond the school). These should be set out clearly in the school’s published SEND policy

Counselling

The British Association for Counselling and Psychotherapy (BACP) define school-based counselling as:

‘a professional activity delivered by qualified practitioners in schools. Counsellors offer troubled and/or distressed children and young people an opportunity to talk about their difficulties, within a relationship of agreed confidentiality.’

Schools are not legally obliged to offer school-based counselling. Therefore there is no automatic right of a child to access counselling for mental health problems within a school.

However the government has issued departmental advice entitled ‘Counselling in schools: a blueprint for the future 2015‘ which suggests strategies that schools can use to set up and/or improve counselling services in primary and secondary schools. 

Child and Adolescent Mental Health Services (CAMHS)

If a school believes that a child or young adult would benefit from a more clinical approach and treatment for mental health difficulties then they can refer the child to CAMHS. CAMHS are specialist NHS children and young people’s mental health services and can offer a variety of trained mental health professionals such as: 

Social Workers                                                 

Outreach Workers

Occupational Therapists                                     

Primary Mental Health Worker

Psychologists                                                   

Family Therapists

Psychotherapists                                               

Counsellors