The Government outlined its proposals for improving mental health provision in children and young people on Monday in its Green Paper, Transforming Children and Young People’s Mental Health Provision.
The Government’s determination to address mental health issues in children and young people is commendable and should be applauded, and represents a political commitment to a very important issue.
The Prime Minister is determined to correct, in her words, the ‘historic injustice’ of unfair discrimination and poor treatment of people with mental health needs.
Support for children and young people in schools and colleges is inconsistent and waiting times to access specialist services are too long. One in ten young people have a diagnosable mental health condition and children with mental health problems face unequal life chances. Half of problems are established before the age of 14.
The proposals in the Green Paper outline a three-pillared approach for addressing mental health needs in children and young people. It is proposed that the three pillars will be rolled out to a fifth to a quarter of the country by the end of 2022-23.
Firstly, it is proposed that a ‘Designated Senior Leader’ for children and young people’s mental health should be appointed in every school. These designated leaders will focus on establishing whole-school approaches which will promote good mental health in children and young people.
This is a significant role in schools and it will ensure students, staff, parents and external agencies have a point of contact should this be needed. Training will be provided to the designated leaders to ensure they have the knowledge to effectively identify and support children with mental health needs.
Early intervention can prevent problems from escalating and schools and colleges play a vital role in identification, intervention and referral. The proposals highlight that the school environment provides a more acceptable and non-stigmatising context for interventions but, at the same time, it can present triggers for difficulties such as social anxiety.
The designated leader will play an important role in deconstructing the school environment to reduce possible triggers for poor mental health and in cascading training to all staff.
Secondly, it is proposed that Mental Health Support Teams will be established to improve the link between schools and local health services. The Mental Health Support Teams will work closely with schools to develop approaches to early intervention and they will deliver evidence-based interventions, including Cognitive Behaviour Therapy, to children and young people with mild to moderate mental health needs.
They will provide extra capacity for early intervention and on-going help. Their work will be managed jointly by schools and the NHS.
Thirdly, there is a proposal to introduce four week waiting times for children and young people who need access to specialist mental health services. Current service provision is at crisis point; Child and Adolescent Mental Health Services (CAMHS) are over-stretched, resulting in extremely long waiting lists and strict referral criteria. This results in the help often coming too late or young people not receiving any form of help.
It is proposed that all children and young people will be taught about mental health and wellbeing through Relationships and Sex Education (RSE) and Personal, Health and Social Education (PHSE).
However, the importance of integrating mental health across the full breadth of the curriculum is not addressed in the Green Paper and this should be given due consideration. For example, subjects such as music, art, drama, English, religious education and history can make important contributions towards mental health.
Additionally, the importance of providing children and young people with an inclusive sex and relationships education (SRE) curriculum is vital in promoting good mental health.
This is also not acknowledged in the Green Paper, although there is acknowledgement in the paper about the link between LGBT and mental health. Schools should ensure that SRE addresses the spectrum of gender and sexual identities so children and young people feel included and we hope this will be addressed in the subsequent White Paper.
It is proposed that new research will be funded, including research in how best to support vulnerable families. The government plans to commission further research into interventions that support parents to improve attachment relationships.
The role of initial teacher training in supporting new teachers to more effectively identify mental health problems and provide appropriate forms of support is highlighted. Additionally, a working group of social media and digital sector companies will be established to explore how to keep children and young people safe on line.
A 12-week consultation period follows the publication of the Green Paper. Whilst we welcome the proposals, we have concerns that the role of the assessment system in contributing to poor mental health in children and young people is not explicitly acknowledged in the Green Paper.
The role of terminal examinations in contributing to test anxiety warrants further consideration. In addition, the marginalisation of a broad and balanced curriculum and recent changes to the curriculum also warrants discussion.
We also have concerns that the proposals, if rolled out, will not reach all children and young people with 75%-80% not receiving the support they need by the end of 2022-23.
The Carnegie Centre of Excellence for Mental Health in Schools
The Carnegie Centre of Excellence for Mental Health in Schools was established in the Carnegie School of Education at Leeds Beckett University in 2017. It was the first national Centre of its kind to be developed in a university. It is supported by Nicky Morgan MP who serves on the Advisory Board.
Working in partnership with Minds Ahead, the Centre has established a Quality Mark which is an accreditation of the mental health provision within schools and colleges. Through a process of auditing current provision, schools and colleges then enhance provision further to work towards the accreditation.
Over 100 educational institutions are currently working towards the Quality Mark.
The Centre has also established a suite of professional development courses for teachers and school leaders. It launches its development programme for school mental health leads, in Leeds on 26th January 2018. We deliver mental health awareness training to trainee teachers on undergraduate and postgraduate initial teacher training programmes and we are leading research into LGBT and mental health.
The Centre has established a Master’s degree in the leadership of mental health in schools which commences in September 2018. The Centre also generates research into whole school approaches for mental health and delivers programmes of professional development to trainee teachers.